1. To obtain information for the proper
presentation of his or her claim in a proceeding held pursuant to chapters 616A to 616D, inclusive, of NRS, an injured
employee or a person who has been authorized by the injured employee to
represent him or her must deliver a written request to his or her insurer or
employer. The insurer or employer shall provide such information to the injured
employee or an authorized representative thereof within 30 days after receipt
of the written request. If, at the time of receipt of the written request from
the injured employee or an authorized representative, the requested information
is in the possession of a third-party administrator, or an organization for
managed care or a provider of health care with whom the insurer has contracted,
the insurer shall take all reasonable steps necessary to obtain such
information.

2. To obtain confidential information
pursuant to subsection 3 of NRS
616B.012, the requesting agency, department or board must deliver to the
insurer a written request that must:

(a) Be written on the official letterhead of the
requesting agency, department or board;

(b) State the purpose for which the requesting
agency, department or board will use the requested information;

(c) Contain all pertinent information available to
the requesting agency, department or board to identify:

(1) The injured employee, including, without
limitation, his or her name, social security number, date of birth and the date
of the injury; or

(2) The employer, including, without
limitation, his or her name, the name and address of the business, the names of
the owners of the business and the employer’s policy number; and

(d) Contain any other information that the insurer
may need to process the request.

Ê The insurer
may require additional information to process the request. The insurer shall
provide the requested confidential information to the requesting agency,
department or board within 30 days after receiving the written request.

3. If a request requires the insurer to
report on more than one employer or more than one injured employee, the head of
the requesting agency, department or board must sign the request. If a request
requires the insurer to report on only one employer or injured employee, either
the head of the requesting agency, department or board or a designated agent
thereof must sign the request.

4. Upon receipt of a written request made
pursuant to the provisions of subsection 5 of NRS 616B.012 by the chief
executive officer of any law enforcement agency of this State, the Administrator
will instruct the insurer to provide the information requested to the chief
executive officer within 30 days after receiving the instructions from the
Administrator. The insurer shall provide the information requested within 30
days after receipt of such an instruction from the Administrator.

5. Any fee charged for providing information
pursuant to this section and NRS
616B.012 may not exceed 30 cents per page. If more than one copy of an item
of information that is requested pursuant to this section is maintained in the
records of an insurer, employer or third-party administrator, or in the records
of an organization for managed care or provider of health care with whom the
insurer has contracted, no fee may be charged for any duplicate copy that is
provided.

(Added to NAC by Div. of Industrial Relations by R208-97,
eff. 4-17-98; A by R112-98, 12-18-98; R118-02, 9-7-2005)

NAC616B.010Maintenance
of files for claims; address to be used for correspondence and other documents.
(NRS
616A.400)

1. Except as otherwise provided in NAC 616B.013, copies of all claim files maintained by
an insurer, third-party administrator or organization for managed care pursuant
to chapters 616A to 617, inclusive, of NRS or regulations
adopted pursuant thereto must be maintained in one of its offices located in
this State.

2. All correspondence and other documents
submitted to an insurer, third-party administrator or organization for managed
care that concern a claim for compensation that is being administered pursuant
to chapters 616A to 617, inclusive, of NRS or regulations
adopted pursuant thereto must be addressed to the insurer, third-party
administrator or organization for managed care at one of its offices located in
this State. The correspondence and documents shall be deemed to be officially
received only if they have been so addressed.

(Added to NAC by Div. of Industrial Relations by R208-97,
eff. 4-17-98; A by R105-00, 1-18-2001, eff. 3-1-2001)

NAC 616B.013Availability, location and inspection of files of claims of
injured workers; report of findings to insurer. (NRS 616A.400)

1. An insurer or third-party administrator
shall ensure that each file of any claim of an injured worker concerning an
industrial injury which is filed in accordance with chapters 616A to 617, inclusive, of NRS or a regulation
adopted pursuant thereto is available for inspection during regular business
hours by:

(a) The injured worker;

(b) The attorney or other authorized representative
of the injured worker;

(c) The Commissioner or a designee thereof; or

(d) The Administrator.

2. All files of the claims of injured
workers concerning industrial injuries must be administered in this State and
be available for inspection at an office of the insurer or third-party
administrator in this State.

3. After reviewing the file of a claim, the
Commissioner or Administrator will report his or her findings to the insurer.

(Added to NAC by Div. of Industrial Relations by R105-00,
1-18-2001, eff. 3-1-2001; A by R007-06, 6-1-2006)

2. The information required pursuant to
subsection 1 must, except as otherwise requested by the Administrator, include
information concerning any administrative activity during the previous fiscal
year relating to:

(a) A claim for an injury that occurred during that
year; and

(b) Any other claims, regardless of when the injury
occurred.

3. As used in this section:

(a) “Claim for accident benefits only” means a
claim in which the benefits received by the injured employee or his or her
dependents for the duration of the claim did not include benefits for a
temporary total disability, temporary partial disability or permanent total
disability.

(b) “Claim for benefits for lost time” means a
claim in which the benefits received by the injured employee or his or her dependents
for the duration of the claim included benefits for a temporary total
disability, temporary partial disability or permanent total disability.

(c) “Vocational rehabilitation maintenance” has the
meaning ascribed to it in NRS
616C.575.

(Added to NAC by Div. of Industrial Relations by R105-00,
1-18-2001, eff. 3-1-2001)

NAC616B.018Notice
to Administrator of accident or exposure to disease-causing agent or fatality
from accident or exposure. (NRS 616A.400)

1. Within 30 days after an insurer receives
notice that an employee has been:

(a) Involved in an accident; or

(b) In close proximity to or has had contact with a
disease-causing agent that may have a harmful effect on the employee,

Ê the insurer
shall notify the Administrator if the accident resulted in injury to, or the
exposure to the disease-causing agent affected or is expected to affect, two or
more persons.

2. Within 48 hours after the insurer
receives notice of a fatality that resulted from:

(a) An accident that an employee was involved in;
or

(b) The close proximity to or contact with a
disease-causing agent by the employee,

Ê the insurer
shall notify the Administrator of the fatality by submitting Form D-21,
Fatality Report, to the Administrator.

(Added to NAC by Div. of Industrial Relations by R105-00,
1-18-2001, eff. 3-1-2001)

NAC616B.021Payment
of compensation, benefit penalty, or penalty for unreasonable delay or refusal
to pay claim. (NRS
616A.400)Not
later than the date that compensation is due to a claimant, an insurer or
third-party administrator shall:

1. Mail a check for compensation, a benefit
penalty or a penalty imposed pursuant to NRS 616C.065 to:

(a) The claimant; or

(b) Upon the written direction of the claimant, the
attorney or other authorized representative of the claimant; or

2. Make a check for compensation, a benefit
penalty or a penalty imposed pursuant to NRS 616C.065 available to the
claimant or, if directed in writing by the claimant, the attorney or other
authorized representative of the claimant in the office of the insurer or
third-party administrator.

(Added to NAC by Div. of Industrial Relations by R105-00,
1-18-2001, eff. 3-1-2001; A by R007-06, 6-1-2006)

REPORTING OF PAYROLL AND PREMIUMS

NAC 616B.023Determination of value of meal as wages. (NRS 616A.400)For the
purpose of determining the average monthly wage used in the calculation of
disability compensation, the reasonable value of a meal furnished by an
employer to an employee is the value, if any, specified in the collective
bargaining agreement between the employee and the employer. Meals will be
valued by the cost to the employer per meal for the purposes of determining
payroll.

(Added to NAC by Div. of Industrial Relations by R112-98,
12-18-98, eff. 7-1-99)

NAC 616B.029Report of change in ownership of business. (NRS 616A.400)An
employer covered by a policy for workers’ compensation shall immediately report
to his or her insurer any change in the ownership of the ongoing business.

(Added to NAC by Div. of Industrial Relations by R112-98,
12-18-98, eff. 7-1-99)

(Added to NAC by Div. of Industrial Relations by R071-99,
eff. 10-29-99)

NAC 616B.109“Designated agent” defined. (NRS 616A.400)“Designated
agent” means the agent who is authorized by the Administrator to receive proof
of coverage from a private carrier or an association, or its representative,
and submit that proof of coverage to the Administrator.

(Added to NAC by Div. of Industrial Relations by R071-99,
eff. 10-29-99; A by R071-99, 10-29-99, eff. 1-1-2000)

NAC 616B.118“Proof of coverage” defined. (NRS 616A.400)“Proof
of coverage” means the information relating to the verification of industrial
insurance coverage for employers in this State.

(Added to NAC by Div. of Industrial Relations by R071-99,
eff. 10-29-99)

1. IAIABC EDI Implementation Guide for
Proof of Coverage, which is published by the International Association of
Industrial Accident Boards and Commissions. A copy of the publication may be
obtained from the International Association of Industrial Accident Boards and
Commissions, 5610 Medical Circle, Suite 24, Madison, Wisconsin 53719, for the
price of $50 for members and $95 for nonmembers.

2. Workers Compensation Policy Data
Reporting Manual, which is published by the National Council on
Compensation Insurance. A copy of the publication may be obtained from the
National Council on Compensation Insurance, Products and Services Department,
901 Peninsula Corporate Circle, Boca Raton, Florida 33487, for the price of
$120 for affiliates and $155 for nonaffiliates.

3. Basic Manual for Workers Compensation
and Employers Liability Insurance, which is published by the National
Council on Compensation Insurance. A copy of the publication may be obtained
from the National Council on Compensation Insurance, Products and Services
Department, 901 Peninsula Corporate Circle, Boca Raton, Florida 33487, for the
price of $108 for affiliates and $149 for nonaffiliates.

4. Forms Manual of Workers Compensation
and Employers Liability Insurance, which is published by the National
Council on Compensation Insurance. A copy of the publication may be obtained
from the National Council on Compensation Insurance, Products and Services
Department, 901 Peninsula Corporate Circle, Boca Raton, Florida 33487, for the
price of $135 for affiliates and $271 for nonaffiliates.

5. Electronic Transmission User’s Guide,
which is published by the National Council on Compensation Insurance. A copy of
the publication may be obtained, free of charge, from the National Council on
Compensation Insurance, Products and Services Department, 901 Peninsula
Corporate Circle, Boca Raton, Florida 33487.

6. Workers
Compensation Data Specifications Manual, which is published by the National
Council on Compensation Insurance. A copy of the publication may be obtained
from the National Council on Compensation Insurance, Products and Services
Department, 901 Peninsula Corporate Circle, Boca Raton, Florida 33487, for the
price of $78.

(Added to NAC by Div. of Industrial Relations by R071-99,
eff. 10-29-99; A by R118-02, 9-7-2005)

NAC 616B.124Private carrier: Duty to submit proof to designated agent. (NRS 616A.400, 616B.460, 616B.461)For the
purposes of complying with the provisions of subsection 2 of NRS 616B.460 and NRS 616B.461, a private carrier
shall submit proof of coverage to the designated agent.

(Added to NAC by Div. of Industrial Relations by R071-99,
eff. 10-29-99; A by R071-99, 10-29-99, eff. 1-1-2000; R118-02, 9-7-2005)

NAC 616B.127Private carrier: Period for submission of proof; duty upon
replacement of binder. (NRS 616A.400, 616B.461)

1. A private carrier shall submit proof of
coverage to the designated agent within 15 days after the effective date of
the:

(a) Issuance of a policy or binder of industrial
insurance;

(b) Renewal of a policy of industrial insurance;

(c) Reinstatement of a policy of industrial
insurance;

(d) Reissuance of a policy of industrial insurance;

(e) Cancellation of a policy of industrial
insurance;

(f) Nonrenewal of a policy of industrial insurance;
or

(g) Issuance of any endorsement of a policy of
industrial insurance which materially affects the proof of coverage required by
NAC 616B.100 to 616B.148,
inclusive.

2. If a binder is submitted as proof of
coverage pursuant to paragraph (a) of subsection 1 and the binder is replaced
by a policy of industrial insurance, proof of coverage for the policy must be
submitted to the designated agent before the expiration of the binder.

3. A private carrier shall submit proof of
coverage to the designated agent within 15 days after receiving notice that an
employer has changed insurers or has cancelled his or her policy with that
carrier.

(Added to NAC by Div. of Industrial Relations by R071-99,
eff. 10-29-99; A by R071-99, 10-29-99, eff. 1-1-2000; R118-02, 9-7-2005)

(b) The United States Postal Service or any other
mail delivery service.

2. If the private carrier does not use Form
D-41, International Association of Industrial Accident Boards and Commissions
POC 1, to submit:

(a) Information relating to a binder, it shall
submit Form D-48, Proof of Coverage Notice, and a schedule of the names,
addresses and federal employer identification numbers of the employers covered
by the binder.

(b) Information relating to a policy, it shall
submit Form D-49, Information Page.

(c) Information relating to the termination,
cancellation or reinstatement of a policy, it shall submit Form D-50, Policy
Termination, Cancellation and Reinstatement Notice.

3. As used in this section, “electronic
transmission” means the sending of information by electronic means in the
manner prescribed by the designated agent, including, without limitation, by a
magnetic tape, cartridge, mainframe or personal computer.

NAC 616B.136Employer: Provision of proof to insurer and Administrator;
notification of previous insurer of cancellation of former policy. (NRS 616A.400, 616B.460)

1. An
employer shall, upon request, provide proof of coverage to its insurer and to
the Administrator in the manner prescribed by the Administrator. If the
employer fails to provide that information to the insurer, the insurer may
notify the Administrator of the failure of the employer to provide the
information.

2. If an employer changes insurers, the
employer shall notify the previous insurer of the cancellation of the former
policy within 10 days after the effective date of the change.

(Added to NAC by Div. of Industrial Relations by R071-99,
eff. 10-29-99; A by R118-02, 9-7-2005)

NAC 616B.139Designated agent: Fee for certain services; provision of
instructions for submission of proof. (NRS 616A.400, 616B.461)The
designated agent may charge a private carrier a fee in an amount that does not
exceed the cost of receiving, processing and submitting proof of coverage
required by the Administrator. The designated agent shall provide to the
private carrier, at no cost, instructions for submitting proof of coverage.

(Added to NAC by Div. of Industrial Relations by R071-99,
eff. 10-29-99; A by R071-99, 10-29-99, eff. 1-1-2000; R118-02, 9-7-2005)

NAC 616B.148Notification of Administrator regarding operation of employer
without insurance. (NRS 616A.400)An
insurer shall, within 5 working days after it obtains information that an employer
may have operated in this State without industrial insurance, give written
notice of that fact to the Administrator.

(Added to NAC by Div. of Industrial Relations by R071-99,
eff. 10-29-99; A by R118-02, 9-7-2005)

1. The standards and procedures of the
Commissioner for certifying self-insured employers; and

2. The regulations of the Administrator
governing the operation of self-insured employers’ programs for providing
workers’ compensation, to provide adequate protection for the self-insured
employers, their employees and the State of Nevada.

[Comm’r of Insurance, PC-25 § 2, eff. 8-6-80]—(NAC A by
Dep’t of Industrial Relations, 10-26-83; A by Comm’r of Insurance, 1-24-92; A
by Div. of Industrial Relations by R112-98, 12-18-98)

NAC 616B.403Definitions. (NRS 679B.130)As used
in NAC 616B.400 to 616B.496,
inclusive, unless the context otherwise requires, the terms defined in chapters 616A to 617, inclusive, of NRS have the meanings
ascribed to them therein. In addition, the words and terms defined in NAC 616B.406 to 616B.421,
inclusive, have the meanings ascribed to them in those sections.

NAC 616B.406“Annual claims expenditures” defined. (NRS 679B.130)“Annual
claims expenditures” means the total amount of money actually disbursed in a
fiscal year by or on behalf of an employer as benefits against all past and
current industrial insurance claims.

NAC 616B.409“Expected annual claims expenditures” defined. (NRS 679B.130)“Expected
annual claims expenditures” means an estimate of the total amount of money to
be disbursed by or on behalf of an employer in the next fiscal year as benefits
against all industrial insurance claims.

NAC 616B.412“Expected annual incurred cost of claims” defined. (NRS 679B.130)“Expected
annual incurred cost of claims” means the result of a calculation in which the
employer’s estimated payroll for the first 12 months of self-insurance is
multiplied by the sum of his or her annual claims expenditures for those claims
initiated during a period of 3 years ending 1 year before the date on which his
or her election to be a self-insured employer is made plus an estimate of the
additional costs, including future costs which are due or may become due, which
will be paid in settlement of those claims, divided by the employer’s total
payroll for the same 3-year period. The term also includes an estimate of the
employer’s cost of administration of his or her program of self-insurance.

NAC 616B.415“Governmental employer” defined. (NRS 679B.130)“Governmental
employer” means the State, any county, city or school district, and all public
and quasi-public corporations in this State.

(Added to NAC by Comm’r of Insurance, eff. 1-4-91)—(Substituted
in revision for NAC 616.149)

NAC 616B.418“Program of self-insurance” defined. (NRS 616A.400, 679B.130)“Program
of self-insurance” means a program of self-insured workers’ compensation
established pursuant to chapters 616A
to 617, inclusive, of NRS for which an
employer has obtained a certificate from the Commissioner.

NAC 616B.424Eligibility to self-insure. (NRS 616B.300, 679B.130)In order
to be eligible to establish a program of self-insurance, an employer must:

1. Except as otherwise provided in NAC 616B.427 and 616B.433,
be a legally qualified business entity having a tangible net worth of at least
$2,500,000.

2. If other than a governmental employer, be
licensed to do business in Nevada.

3. Make the deposit required by NAC 616B.436. If the business has been operated at a
loss in any of the past 3 years, the Commissioner may increase the required
deposit by a minimum amount of 20 percent of the deposit.

4. Present evidence that the business has
administrative resources which will enable it to timely report, administer and
settle all claims. The resources which are necessary include, but are not
limited to:

(a) The ability of the employer to know and
correctly apply the worker’s compensation laws and regulations of this State;

(b) A qualified, licensed and competent
administrator of the program who is located in Nevada;

(c) An existing and feasible plan for the program
of self-insurance which provides for an immediate and personal response to an
employee’s claim;

(d) A plan for the administration of claims which
includes written instructions or examples of how to apply the worker’s
compensation law to ensure continuity of service to employees as well as ease
of audit by company personnel and regulatory agencies;

(e) The ability to communicate the plan for the
administration of the program, including such topics as benefits, filing
procedures and the right of appeal, to the appropriate managers of the business
and to all employees; and

(f) Standards of performance for the administration
of the program of self-insurance.

1. To determine whether a governmental
employer has the financial ability to qualify as a self-insured employer, the
Commissioner will consider the use of fund accounting and waive the requirement
for a tangible net worth found in NAC 616B.424.
All other requirements for qualification apply to the governmental entity.

2. In addition to the deposit required by NRS 616B.300, a governmental
entity that does not meet the requirements of subsection 1 shall:

(a) Comply with the requirements of Statement No. 10
of the Governmental Accounting Standards Board, which may be obtained from the
Governmental Accounting Standards Board, 401 Merritt 7, P.O. Box 5116, Norwalk,
Connecticut 06856-5116, or on the Internet at http://www.gasb.org, at a
cost of $22.50; or

(b) Set aside, in a special reserve account, an
amount equal to the deposit it made with the Commissioner to assure payment of
claims. This account must be held in trust for the payment of claims, and all
interest and income earned must be credited to that account. If securities are
used for this account, then the form of the securities must be submitted to the
Commissioner for approval.

1. Every employer desiring to qualify as a
self-insured employer must apply to the Commissioner on forms provided by the
Commissioner. The application must be signed by an executive officer of the
corporation, include audited financial statements of the business entity
covering the 3 years immediately preceding the date of the application and be
accompanied by an application fee of $200 for each application submitted. The
fee will not be refunded.

2. A separate application and filing fee
must be submitted for each separately administered program.

1. To determine the tangible net worth, as
defined in NRS 616A.330, of a
self-insured employer, he or she shall submit to the Commissioner all financial
statements and accompanying footnotes, including an independent auditor’s
opinion. Each statement must be audited.

2. The following factors must be used to
review the audited financial statements:

(a) The auditor’s opinion.

(b) The various financial ratios, including working
capital and cash flow.

(c) Any footnotes related to:

(1) A contingency or commitment;

(2) A party;

(3) A bad debt; or

(4) The restructuring of an operation.

3. If any of the factors in subsection 2 are
deemed material, the Commissioner may deny certification.

4. If, after the adjustments are made
pursuant to subsection 1, the employer’s statement demonstrates a strong
financial position and meets the tests in subsection 2, the Commissioner may
accept as an additional deposit any instrument described in NAC 616B.436 in the amount of $2,500,000 in lieu of
the requirement set forth in subsection 1 of NAC
616B.424. The deposit described in this subsection must be separate from
the deposit required pursuant to NRS
616B.300.

(Added to NAC by Comm’r of Insurance, eff. 1-4-91; A by
R112-04, 8-25-2004; R119-07, 12-4-2007)

1. Except as otherwise provided in
subsection 3 of NRS 616B.300,
a self-insured employer shall meet the deposit requirement of the self-insured
program of workers’ compensation by depositing with the Commissioner any of the
following:

(a) Cash.

(b) A certificate of deposit, from a financial
institution in this State that is insured federally, made payable to the
Commissioner of Insurance and the employer.

(c) The following securities, if they have a date
of maturity that is not more than 1 year:

(1) Any obligation guaranteed by the full
faith and credit of the United States, including:

(I) United States treasury notes;

(II) United States treasury bills; and

(III) Internal money market funds related
to United States treasury notes or treasury bills, if the account is maintained
with a financial institution in this State and does not exceed $10,000; or

(2) Any obligation of an agency of the United
States, including the Federal National Mortgage Association, Federal Housing
Finance Board and Federal Home Loan Mortgage Corporation, that is guaranteed by
the full faith and credit of the United States. If the obligation is an
internal money market fund related to the Federal National Mortgage
Association, Federal Housing Finance Board or Federal Home Loan Mortgage
Corporation, the account must be maintained with a financial institution in
this State and may not exceed $10,000.

Ê The
securities deposited in compliance with this paragraph must have a fair market
value of not less than 105 percent of the employer’s expected annual incurred
cost of claims, unless reduced by excess insurance in an amount approved by the
Commissioner.

(d) A surety bond, if it is:

(1) Written by an insurer authorized and
licensed to transact the business of surety insurance in this State; and

(2) Countersigned by a producer of insurance
appointed by the insurer.

(e) A letter of credit that meets the standards set
forth in NAC 616B.439.

(f) Any combination of cash, certificates of
deposit, securities guaranteed by the full faith and credit of the United
States, surety bonds or letters of credit. Priority of payment in case of loss
must be in the order stated in this paragraph.

2. Securities guaranteed by the full faith
and credit of the United States that are deposited in accordance with this
section will be held in trust and administered by the Commissioner, unless:

(a) The self-insured employer elects to use the
services of a custodial financial institution in this State for trust
investments;

(b) The custodial financial institution holds and
administers the securities on behalf of the Commissioner under an agreement
approved by the Commissioner; and

(c) The custodial financial institution provides
monthly statements of the account to the Division of Insurance of the
Department of Business and Industry. The accuracy of each such statement must
be certified monthly by a trust officer of the financial institution.

Ê A deposit
made pursuant to this subsection may not be withdrawn except upon written order
of the Commissioner. A deposit must be revised on or before June 30 each year
or as the Commissioner determines to be appropriate and necessary.

3. If necessary, the Commissioner may select
a competent specialist to make an evaluation:

(a) Before accepting for deposit any security of
the United States or asset; or

(b) At any time after the security of the United
States or asset is deposited with the Commissioner or held by a custodial
financial institution in this State.

Ê The
self-insured employer shall pay the cost of any such evaluation.

4. As used in this section, “producer of
insurance” has the meaning ascribed to it in NRS 679A.117.

1. A letter of credit submitted by a
self-insured employer to meet the requirements for his or her deposit pursuant
to NAC 616B.436 must:

(a) Include a clause stating that no document other
than the demand for payment under the terms of the letter is necessary for
payment.

(b) Be irrevocable.

(c) Be valid for at least 1 year. The letter must
not expire unless written notice is given by the issuer. It must be renewable
automatically, unless the issuer gives written notice to the Commissioner and
the employer at least 90 days before the expiration date.

(d) Be issued by a bank chartered by this State or
a bank that is a member of the United States Federal Reserve System and has
been approved by the Commissioner.

(e) Include a clause stating that it is not subject
to any conditions or qualifications outside the letter. The letter may be the
individual obligation of the financial institution issuing it, but must not be
contingent upon the institution’s ability to perfect any lien or security
interest. The letter must not contain references to any other agreements,
documents or persons.

(f) Include a clause stating that the obligation of
the financial institution under the letter is not contingent upon
reimbursement.

2. The heading of the letter of credit may
include a boxed section containing the name of the applicant and other
appropriate notations. If such a section is present it must be marked clearly
to indicate that the information is for internal identification only, and does
not affect the terms of the letter or the financial institution’s obligations
under the letter.

(Added to NAC by Comm’r of Insurance, eff. 1-4-91; A by
R139-99, 1-27-2000)

NAC 616B.442Maintenance and review of documents to ensure adequacy of
security deposit. (NRS 616B.300, 679B.130)A self-insured
employer shall maintain such documents as are necessary to ensure the adequacy
of the security deposit required by NRS
616B.300. To determine the accuracy of the recorded and reported amounts
for claim reserves, the self-insured employer shall maintain and the
Commissioner will review:

1. A list of open and closed claims, which
include:

(a) The claimant’s name;

(b) The number assigned to the claim;

(c) The date of the injury;

(d) The status of the claim, including whether it
is open or closed;

(e) The total reserve amount for medical and
indemnity for each claim;

(f) The total amount paid for medical costs and
indemnity for each claim;

(g) The total reserve balance for medical costs and
indemnity for each claim;

(h) The total incurred cost of each claim;

(i) The total for all claims of payments for
medical costs and indemnity; and

(j) The total of reserve balances for all open
claims, including future liabilities for medical costs and indemnity.

2. A list of claims covered or paid by
excess insurance.

3. The cost of administration of claims.

(Added to NAC by Comm’r of Insurance, eff. 1-4-91)—(Substituted
in revision for NAC 616.163)

NAC 616B.445Authority of Commissioner to require guarantee of
indemnification. (NRS 616B.300, 679B.130)A
guarantee of indemnification may be required by the Commissioner from:

1. A parent corporation for its subsidiaries
or affiliates;

2. Any partner for a partnership; or

3. An owner for a sole proprietorship,
whether or not the indemnitor is seeking a certificate of self-insurance for
himself or herself.

(Added to NAC by Comm’r of Insurance, eff. 1-4-91)—(Substituted
in revision for NAC 616.165)

1. A self-insured employer shall at all
times maintain adequate resources for the administration of his or her program
of self-insurance. After the program is established, the adequacy of the
resources and standards of performance of the self-insured employer for the program
will be evaluated by the Commissioner and the Administrator, or a
representative of either of them, on the basis of:

(a) The self-insured employer’s promptness in
filing reports of accidents and occupational disease;

(b) The self-insured employer’s promptness in
making first payments in cases of uncontested claims;

(c) The percentage of contested claims;

(d) The number of injured employees who are
reemployed or rehabilitated; and

(e) The delay between the termination of
compensation for temporary disabilities and the payment of compensation for
permanent partial disabilities.

2. A self-insured employer may contract with
another person or entity for the administration of his or her program of
self-insurance. The acts of a person or entity in carrying out that
administration shall be deemed the acts of the self-insured employer for the
purposes of NAC 616B.400 to 616B.496, inclusive, and NRS 616D.120, and the
self-insured employer is at all times responsible for compliance with chapters 616A to 618, inclusive, of NRS unless
specifically excepted by the provisions on self-insurance in those chapters.

3. The self-insured employer shall inform
the Commissioner and the Administrator, or a representative of either of them,
of the names, titles and business addresses of the persons or entity with whom
he or she contracts to administer his or her program of self-insurance and the
location or locations of the records required to be kept pursuant to NAC 616B.400 to 616B.496,
inclusive. Before any change is made in the name, title or address of a person
or entity administering the employer’s program or any change is made in the
location of records, the intended change must be reported in writing to the
Commissioner and the Administrator or a designated agent thereof.

4. A self-insured employer shall not
administer a program of self-insurance from a location outside this State.

[Comm’r of Insurance, PC-25 § 16 + part § 26, eff. 8-6-80]—(NAC
A by Div. of Industrial Insurance Regulation, 10-26-83; A by Div. of Industrial
Relations by R112-98, 12-18-98)

1. A self-insured employer may request that
the Commissioner issue one certificate of authority to cover the employer and
any subsidiary or affiliated corporation. In reviewing such a request, the
Commissioner will apply the standards of NAC 616B.424
to all of the subsidiaries and corporations as if they were a single entity.

2. The businesses that wish to be covered by
one certificate shall file a statement with the Commissioner that lists the
owners of the businesses and the percentage of the businesses held by each
owner and that verifies that the operations of each business are controlled by
the same owners. The Commissioner may require each business, or the owner of
each business, or both, to indemnify the other businesses or owners who will be
covered by the certificate and hold them harmless from liability for any claim for
compensation filed pursuant to chapters
616A to 617, inclusive, of NRS.

3. The Commissioner may issue one
certificate to cover a business and one or more subsidiaries or affiliated
corporations if:

(a) The operations of each business are controlled
by the same natural persons or corporation; and

(b) An independent auditor determines that there is
sufficient similarity in the control of the businesses to present a combined
financial statement for all of the businesses that will be covered by the
certificate.

4. A certificate issued by the Commissioner
pursuant to this section will list the names and locations of all the
businesses covered by the certificate.

5. If the self-insured employer later
requests that a new business or a new location be added to the certificate, the
Commissioner will review that request in accordance with this section. If
approved, a new certificate will be issued to the self-insured employer and
list all covered businesses or locations. The self-insured employer shall
return the original certificate to the Commissioner.

6. As used in this section, “affiliated
corporation” means a corporation that directly or indirectly, through one or
more intermediaries, is controlled by, or is under common control with, the
self-insured employer.

(Added to NAC by Comm’r of Insurance, eff. 1-4-91; A 3-22-96)—(Substituted
in revision for NAC 616.169)

1. Every self-insured employer must file an
annual report on forms supplied by the Commissioner as a condition to the
continuance of his or her certificate of authority to self-insure.

2. The report must be filed on or before
September 30, or within an additional time allowed by the Commissioner, and
cover the preceding fiscal year.

3. Unless otherwise approved by the
Commissioner, the report must be signed by a person administering the program
of self-insurance and by an officer or authorized employee of the self-insured
employer.

4. A self-insured employer will be assessed
a penalty of $50 for each day in which he or she has failed to file the annual
report as required by this section.

5. The Commissioner may require a
self-insured employer to submit quarterly reports in addition to the annual
report.

1. A self-insured employer must calculate
the estimated expenditure for each claim reported in the annual report. The
estimated expenditure for a claim is the total liability attributable to the
industrial accident or occupational disease, and includes the total amount of
money disbursed as benefits for the claim and the estimated additional cost,
including future costs actually and potentially due, which may result from the
settlement of a claim, regardless of when it will be paid.

2. The Commissioner may revise the estimated
expenditure for a claim which, in his or her opinion, is inaccurate or
inadequate. A revision will be made only after the self-insured employer has
been notified in writing and given an opportunity to object to it.

3. A reserve for reopened claims will be
calculated by the Division of Insurance based upon a percentage of the actual
expenses paid on all closed claims. The percentage will be based upon the
following sliding scale according to the number of uninterrupted years the
employer has been in the self-insured program:

(a) Inception to 5 years in the program, 3 percent;

(b) Six to 10 years in the program, 2 percent;

(c) Eleven to 15 years in the program, 1 percent;
and

(d) More than 15 years in the program, 0.5 percent.

4. The number of years an employer has been
self-insured will be based upon the State’s fiscal year beginning July 1 and
ending June 30. If the date of certification is on or before December 31, a
full year will be calculated for the first year of certification. If the date
of certification is January 1 or after, the beginning year of certification
will not be counted. The number of uninterrupted years an employer has been
self-insured will be calculated from the last date on which he or she was
certified a self-insured employer.

[Comm’r of Insurance, PC-25 § 22, eff. 8-6-80]—(NAC A 1-24-92)

NAC 616B.469Submission of interim reports regarding occurrence of certain
injuries and diseases. (NRS 679B.130)Each
self-insured employer must submit to the Division of Insurance of the Department
of Business and Industry the following interim reports as a condition for the
continuance of his or her certificate of authority to self-insure:

1. Any injury or disease expected to result
in the payment of at least $100,000 for medical costs or indemnity, or which
will trigger excess insurance coverage, must be reported to the Commissioner
within 30 days after the actual occurrence of the claim or the projection of
the reserve. The report must contain:

(a) The name of the claimant and the date and type
of injury;

(b) The amount paid to date for medical costs and
indemnity;

(c) The projected amount of reserves that have been
established; and

(d) The amount paid, or anticipated to be paid, by
excess insurance.

2. Any injury involving five or more
employees for the same accident must be reported to the Commissioner within 30
days after the actual occurrence. The report must contain:

(a) The names of the claimants and the dates and
types of injuries;

(b) The amount paid to date for medical costs and
indemnity;

(c) The projected amounts of reserves that have
been established; and

(d) The amount anticipated to be paid by excess
insurance.

(Added to NAC by Comm’r of Insurance, eff. 1-24-92; A
by R112-04, 8-25-2004)

1. Except as otherwise provided in
subsection 10, a self-insured employer may purchase an annuity payable to an
employee who has filed a claim pursuant to chapters 616A to 617, inclusive, of NRS, or to the
employee’s beneficiary, for the compensation owed to the employee as a result
of an industrial injury or occupational disease, except accident benefits, if:

(a) The annuity is purchased from an insurer
authorized to do business in this State;

(b) The employee or the beneficiary is the
annuitant and all payments made pursuant to the annuity will be made directly
to the employee or the beneficiary; and

(c) The purchase of the annuity by the self-insured
employer on behalf of the employee is made to provide compensation owed to the
employee or the beneficiary pursuant to chapters
616A to 617, inclusive, of NRS.

2. The
purchase of an annuity pursuant to this section does not:

(a) Settle the employee’s claim for compensation;

(b) Prohibit the employee from reopening or
contesting the claim; or

(c) Transfer the responsibility of the self-insured
employer to provide, in a timely manner, accurate payments of compensation owed
to the employee to the insurer or any other party.

3. Each contract for an annuity purchased
pursuant to this section must set forth the provisions of subsections 1 and 2.

4. An annuity purchased pursuant to this
section may not be assigned.

5. A self-insured employer who purchases an
annuity pursuant to this section shall make all payments required for the
purchase of the annuity.

6. The amount of the total payments made to
an employee pursuant to an annuity purchased pursuant to this section may not
be less than the amount of compensation, other than accident benefits, owed to
the employee pursuant to chapters 616A
to 617, inclusive, of NRS.

7. A self-insured employer who purchases an
annuity pursuant to this section:

(a) Shall classify the purchase of the annuity as
an amount paid for indemnity; and

(b) May reduce his or her reserve balance for
indemnity for the claim by the amount of compensation owed to the employee
pursuant to chapters 616A to 617, inclusive, of NRS for the period
covered by the annuity.

8. A self-insured employer shall submit to
the Commissioner, with the annual report required by NAC
616B.460, a list which sets forth each annuity he or she purchased, if any,
in the preceding year. The self-insured employer shall provide the following
information for each annuity listed in the report:

(a) The name of the employee on whose behalf the
annuity was purchased;

(b) The number assigned to the claim by the
self-insured employer;

(c) The number of the contract for the annuity;

(d) The amount paid for the annuity; and

(e) The name of the insurer who issued the annuity.

9. An insurer who sells an annuity to a
self-insured employer shall, within 10 days after the contract for the annuity
is executed, submit a copy of that contract to the Commissioner and the
self-insured employer.

10. A self-insured employer may, upon the
approval of the Commissioner, purchase an annuity to pay the accident benefits
owed to an employee incurred as a result of an industrial injury or
occupational disease.

(Added to NAC by Comm’r of Insurance, eff. 11-1-96)

NAC 616B.472Payment of claim with immediately negotiable instrument. (NRS 679B.130)A
self-insured employer must issue all payments for claims, including payments
made pursuant to an annuity, on instruments that are immediately negotiable in
this State pursuant to NRS
687B.255 as a condition for the continuance of his or her certificate of
authority to self-insure.

1. If, during the initial year of
self-insurance, the employer adds an activity for which employees are covered
by self-insurance, the employer must pay an additional assessment which is
equivalent to 0.5 percent of the expected annual expenditures for claims
applicable to the activity which was added.

2. Each self-insured employer will be assessed
an annual assessment equal to .25 percent of the security deposit established
for the self-insured employer on June 30th before the assessment. The
Commissioner will mail, by regular mail, each self-insured employer a notice
specifying the amount of the assessment and the date that it is due, at least
20 days before that date.

3. The annual assessment established in
subsection 2 will not be imposed:

(a) In the fiscal year in which a self-insured
employer is first certified; or

(b) If the balance of the Reserve Account exceeds:

(1) Three million dollars; or

(2) An amount equivalent to 20 percent of the
aggregate of security deposits required of all self-insured employers,

Ê whichever is
the greater amount.

(Added to NAC by Comm’r of Insurance, eff. 7-2-84)—(Substituted
in revision for NAC 616.1965)

1. If a self-insured employer fails to pay
compensation as a result of being insolvent as provided in NRS 616B.306, the Commissioner
may use the Reserve Account, on behalf of that employer to:

(a) Directly pay compensation to the employees of
the employer pursuant to chapters 616A
to 616D, inclusive, or chapter 617 of NRS; or

(b) Retain an administrator who shall, under the
direction of the Commissioner, assume the responsibility for the administration
of claims and payment of compensation pursuant to chapters 616A to 617, inclusive, of NRS.

2. A payment of a claim and the
administrative cost from the Reserve Account does not release the self-insured
employer or the surety from the employer’s responsibility to pay the amounts
due under chapters 616A to 617, inclusive, of NRS. The self-insured
employer or the surety shall reimburse the Reserve Account for any expense
incurred in the payment of claims on its behalf.

(Added to NAC by Comm’r of Insurance, eff. 7-2-84)—(Substituted
in revision for NAC 616.197)

1. Except as otherwise provided in
subsection 3, if the Commissioner determines that the balance in the Reserve
Account is insufficient to pay compensation on behalf of an insolvent
self-insured employer or if an insolvent self-insured employer fails to
reimburse the Account, the Commissioner will assess all employers certified as
self-insurers on the date of the assessment, an amount determined by the
Commissioner to either pay claims or restore the balance of the Reserve
Account. After determining the amount necessary for the assessment, the
Commissioner will mail, by regular mail, each self-insured employer a notice
specifying the amount of the assessment and the date that it is due, at least
20 days before that date.

2. Each self-insured employer shall remit,
on the date specified in the notice, to the Commissioner the total amount of
the assessment. Failure by a self-insured employer to pay an assessment is
prima facie evidence that the employer has intentionally failed to comply with
the regulations of the Commissioner and is grounds for the imposition of a fine
or the withdrawal of the certification as a self-insured employer pursuant to NRS 616B.318.

3. If:

(a) The Reserve Account has been used to pay the
claims of an insolvent self-insured employer;

(b) That self-insured employer fails to reimburse
the Reserve Account; and

(c) The Commissioner determines that the balance of
the Reserve Account is sufficient to pay compensation on behalf of other
insolvent self-insured employers,

Ê the
Commissioner may decide not to impose an assessment pursuant to this section
against employers certified as self-insured employers on that date.

(Added to NAC by Comm’r of Insurance, eff. 7-2-84; A by
R139-99, 1-27-2000)

NAC 616B.487Cancellation of certificate by employer. (NRS 616B.312, 679B.130)A
self-insured employer may at any time request in writing that his or her
certificate to self-insure be cancelled. The Commissioner of Insurance will
withdraw the certificate after the self-insurer:

1. Establishes a program to the satisfaction
of the Commissioner which will discharge all liabilities and responsibilities
incurred by him or her during the period the certificate was in force and which
is in addition to the deposit retained by the Commissioner as provided by
statute; and

1. The failure of a self-insured employer to
comply with the applicable statutes and regulations governing the
administration of self-insured workers’ compensation is cause for withdrawal of
his or her certificate.

2. Proceedings to withdraw a certificate
issued pursuant to NAC 616B.400 to 616B.496, inclusive, will be conducted in accordance
with chapters 616A to 616D, inclusive, of NRS and regulations
adopted pursuant to those chapters.

3. Before the Commissioner issues a formal
written notice that he or she intends to withdraw the certificate of a
self-insured employer, the Commissioner will request in writing that the
employer meet with him or her informally to discuss and resolve the deficiencies
that would be grounds for withdrawal. If the self-insured employer declines to
meet informally with the Commissioner, fails to respond to the request for a
meeting or fails to appear at the scheduled meeting, the Commissioner will
proceed to withdraw the certificate in accordance with the provisions of chapters 616A to 616D, inclusive, of NRS.

1. After the withdrawal of a certificate,
the Commissioner and Administrator retain jurisdiction over injuries sustained
during the period of self-insurance until all liabilities and all
responsibilities have terminated.

2. The Commissioner and Administrator will
require a self-insured employer whose certificate has been withdrawn to provide
any necessary reports setting forth the status of all compensable cases which
remain open.

3. The Commissioner and Administrator will
audit the compensable claims of any self-insured employer whose certificate has
been withdrawn, and the employer shall pay the expenses incurred by the
Commissioner and Administrator, or a representative of either of them, in
conducting the audits.

[Comm’r of Insurance, PC-25 § 32, eff. 8-6-80]—(NAC A
by Div. of Industrial Insurance Regulation, 10-26-83; A by Div. of Industrial
Relations by R112-98, 12-18-98)

NAC 616B.496Severability. (NRS 616A.400, 679B.130)If any
provision of NAC 616B.400 to 616B.496, inclusive, or its application to any
person, thing or circumstance is held to be invalid, the Commissioner and
Administrator intend that the invalidity not affect the other provisions of
those sections to the extent that they can be given effect.

[Comm’r of Insurance, PC-25 § 33, eff. 8-6-80]—(NAC A
by Div. of Industrial Insurance Regulation, 10-26-83; A by Div. of Industrial
Relations by R112-98, 12-18-98)

(Added to NAC by Comm’r of Insurance, eff. 3-22-96; A
11-1-96; A by Div. of Industrial Relations by R006-97, 12-9-97; A by Comm’r of
Insurance by R090-98, 9-18-98; A by Div. of Industrial Relations by R112-98, 12-18-98;
A by Comm’r of Insurance by R112-04, 8-25-2004; R119-07, 12-4-2007)

NAC 616B.513“Annual claims expenditures” defined. (NRS 616B.446, 679B.130)“Annual
claims expenditures” means the total amount of money actually disbursed in a
fiscal year by or on behalf of an association of self-insured public or private
employers as benefits against all past and current claims for industrial
insurance.

NAC 616B.519“Division of Insurance” defined. (NRS 616B.446, 679B.130)“Division
of Insurance” means the Division of Insurance of the Department of Business and
Industry.

(Added to NAC by Comm’r of Insurance, eff. 3-22-96)

NAC 616B.522“Expected annual incurred cost of claims” defined. (NRS 616B.446, 679B.130)“Expected
annual incurred cost of claims” means the result of a calculation in which the
estimated aggregate payroll for all of the members of an association for the
first 12 months of self-insurance is multiplied by the sum of their annual
claims expenditures for those claims initiated during a period of 3 years
ending 1 year before the date on which the association’s election to be
self-insured is made plus an estimate of the additional costs, including future
costs which are due or may become due, which will be paid in settlement of
those claims, divided by the aggregate payroll for all of the members of the
association for the same 3-year period. The term also includes an estimate of
the association’s cost of administering the claims arising from its program of
self-insurance.

1. A statement of the amount of the
association’s money that the initial third-party administrator of the
association will control in the 12 months that follow the date of the
application.

2. A statement of the amount of the
association’s money that the association’s administrator will control in the 12
months that follow the date of the application.

3. The plan required by NRS 616B.416 for payment of
annual assessments by members of the association. The plan may specify that a
portion of the assessment, in an amount approved by the Commissioner, will be
charged against each member before certification to pay expenses that arise in
the certification process. The portion of the assessment that is charged before
certification must be credited against the total annual assessment owed by the
member.

(Added to NAC by Comm’r of Insurance, eff. 3-22-96)

NAC 616B.528Underwriting plan and related policies and guidelines: Submission
required with application for certification; submission of proposed changes. (NRS 616B.350, 616B.446, 679B.130)An
association shall submit to the Commissioner, as part of its application for
certification, a complete copy of its underwriting plan and its policies and
guidelines for accepting members. Any change made to the underwriting plan must
be submitted to the Commissioner before adoption by the association.

(Added to NAC by Comm’r of Insurance, eff. 3-22-96)

NAC 616B.531Remission of assessment for Account for Insolvent Associations of
Self-Insured Employers. (NRS 616B.443, 616B.446, 679B.130)Before
the Commissioner will issue a certificate to an association, the association
must remit to the Commissioner an assessment for the Account for Insolvent
Associations of Self-Insured Public or Private Employers of 1 percent of the
amount of the security which it must deposit pursuant to paragraph (d) of
subsection 1 of NRS 616B.353.
The assessment will be deposited with the State Treasurer to the credit of the
Account for Insolvent Associations of Self-Insured Public or Private Employers.

1. The Commissioner will determine the
amount of security an association must deposit pursuant to paragraph (d) of
subsection 1 of NRS 616B.353
by calculating an amount that is one-half of the association’s expected annual
incurred cost of claims and increasing or decreasing that amount, if necessary
and within the limitations set forth in subsection 2, based on:

(a) The past and future experience of the
association with losses and expenses;

(b) The hazard of catastrophic loss for the
association or the type of employers who are members of the association;

(c) The current trends concerning losses within the
State;

(d) The nature of the businesses of the members of
the association;

(e) The financial ability of the association to pay
all compensation due under chapters 616A
to 617, inclusive, of NRS;

(f) The probable stability and longevity of the
operation of the association; and

(g) Such other contingencies as the Commissioner
deems necessary.

2. Except as otherwise provided in
subsection 3, the amount of security required must not be less than $100,000
and must not exceed an amount equal to the sum of two times the amount of the
self-insured retention maintained by the association pursuant to its policy of
aggregate excess insurance and the annual amount paid out for the
administration of claims.

3. The Commissioner may adjust the amount of
security required if he or she determines that changed conditions warrant such
an adjustment, except in no case may the amount be less than $100,000.

(a) Include a statement that no document other than
the demand for payment under the terms of the letter is necessary for payment.

(b) Be irrevocable.

(c) Be valid for at least 1 year and automatically
renew for each following year unless written notice is given by the issuer to
the Commissioner and the association at least 90 days before the date of
renewal.

(d) Be issued by a bank chartered by this State or
a bank that is a member of the United States Federal Reserve System and has
been approved by the Commissioner.

(e) Include a statement that it is not subject to any
conditions or qualifications other than the terms stated in the letter. The
letter may be the individual obligation of the financial institution issuing
it, but must not be contingent upon the institution’s ability to perfect any
lien or security interest. The letter must not contain references to any other
agreements, documents or persons.

(f) Include a statement that the obligation of the
financial institution under the letter is not contingent upon reimbursement.

2. The heading of the letter of credit may
include a boxed section containing the name of the association and other
appropriate notations. If such a section is present, it must be marked clearly
to indicate that the information is for internal identification only, and does
not affect the terms of the letter or the financial institution’s obligations
under the letter.

(Added to NAC by Comm’r of Insurance, eff. 3-22-96; A
by R139-99, 1-27-2000)

NAC 616B.546Required security deposit: Records; maintenance and review of
lists of claims; costs of administration. (NRS 616B.353, 616B.446, 679B.130)An
association shall maintain such records as are necessary to document that it
maintains an adequate amount for a security deposit pursuant to NRS 616B.353. To determine the
accuracy of the recorded and reported amounts for claim reserves, the
association shall maintain and the Commissioner will review:

1. A list of open and closed claims, which
must include:

(a) The claimant’s name;

(b) The number assigned to the claim;

(c) The date of the injury;

(d) The status of the claim, including whether it
is open or closed;

(e) The total reserve amount for medical costs and
indemnity for each claim;

(f) The total amount paid for medical costs and
indemnity for each claim;

(g) The total reserve balance for medical costs and
indemnity for each claim;

(h) The total incurred cost of each claim;

(i) The total for all claims of payments for medical
costs and indemnity; and

(j) The total of reserve balances for all open
claims, including future liabilities for medical costs and indemnity.

1. Except as otherwise provided in
subsection 2, a third-party administrator of an association shall deposit with
the Commissioner a bond in the amount of $1,000 for each $100,000, or portion
thereof, of the association’s money which he or she will control in the next
calendar year, less the amount of any bond that he or she must file pursuant to
NRS 683A.0857. The
Commissioner may require a third-party administrator to increase the amount of
the bond if there is an increase in the amount of the association’s money that
he or she controls.

2. The maximum bond required pursuant to
this section is $1,000,000.

3. On or before April 1 of each year, a
third-party administrator of an association shall file with the Commissioner a
statement of the actual amount of the association’s money that he or she
controlled in the previous calendar year and the amount of the association’s
money that he or she expects to control in the next calendar year.

(Added to NAC by Comm’r of Insurance, eff. 3-22-96; A
by R139-99, 1-27-2000)

1. Except as otherwise provided in
subsection 2, an association’s administrator shall deposit with the
Commissioner a bond in the amount of $1,000 for each $100,000, or portion
thereof, of the association’s money which he or she will control.

2. The minimum bond required pursuant to
this section is $100,000. The maximum bond required pursuant to this section is
$1,000,000.

3. On or before April 1 of each year, the
association’s administrator shall file with the Commissioner a statement of the
actual amount of the association’s money that he or she controlled in the
previous calendar year and the amount of the association’s money that he or she
expects to control in the next calendar year.

(Added to NAC by Comm’r of Insurance, eff. 3-22-96; A
by R139-99, 1-27-2000)

1. Except as otherwise provided in subsection
3, each approved member of an association shall, within 120 days after the
close of the fiscal year of the member, submit to the association’s
administrator or an independent certified public accountant who has been
designated by the board of trustees of the association a financial statement
for the member which:

(a) Has been prepared by a certified public
accountant in accordance with generally accepted accounting principles of the
United States; and

(b) Is stated in United States dollars.

2. The association must make all financial
statements received from members pursuant to this section available for
inspection by the Commissioner or a designee thereof.

3. The members of an association that has
provided a solvency bond to the Commissioner are not required to comply with
this section.

1. An association shall at all times
maintain adequate resources for the administration of its program of
self-insurance. After the program is established, the adequacy of the
association’s resources and standards of performance for the program will be
evaluated by the Commissioner and the Administrator, or a representative of
either of them, on the basis of:

(a) The association’s promptness in filing reports
of accidents and occupational disease;

(b) The association’s promptness in making first
payments in cases of uncontested claims;

(c) The percentage of contested claims;

(d) The number of injured employees who are
reemployed or rehabilitated; and

(e) The delay between the termination of
compensation for temporary disabilities and the payment of compensation for
permanent partial disabilities.

2. For the purposes of NAC 616B.510 to 616B.612,
inclusive, and NRS 616D.120,
the acts and omissions of a third-party administrator or an association’s
administrator, including, without limitation, any violations or failures to
comply with chapters 616A to 618, inclusive, of NRS, shall be deemed
to be the acts or omissions of the association.

3. An association shall inform the
Commissioner and the Administrator, or a representative of either of them, of
the name, title and business address of its third-party administrator and
association’s administrator and the location of any records that the
association is required by law to maintain. Before any change is made in the
name, title or address of a third-party administrator or an association’s
administrator or any change is made in the location of records, the intended
change must be reported in writing to the Commissioner and the Administrator or
a designated agent thereof.

4. An association shall not administer a
program of self-insurance from a location outside this State.

(Added to NAC by Comm’r of Insurance, eff. 3-22-96; A
by Div. of Industrial Relations by R112-98, 12-18-98)

1. As a condition to the continuance of its
certification, an association must file, on forms supplied by the Commissioner,
a report on claims filed with the association in the previous fiscal year.

2. The annual report on claims must be filed
on or before September 30 of each year, or within an additional time allowed by
the Commissioner.

3. Unless otherwise approved by the
Commissioner, the annual report on claims must be signed by the third-party
administrator of the association, the association’s administrator and by an
authorized member of its board of trustees.

4. An association will be assessed an
administrative fine of $50 for each day in which it has failed to file the
annual report on claims.

5. The Commissioner may require an
association to submit quarterly reports on claims in addition to the annual
report on claims.

1. An association shall calculate the
estimated expenditure for each claim reported in the annual report on claims.
The estimated expenditure for a claim is the total liability attributable to
the industrial accident or occupational disease, including the total amount of
money disbursed as benefits for the claim, and the estimated additional cost,
including future costs actually and potentially due, which may result from the
settlement of a claim, regardless of when it will be paid.

2. The Commissioner may revise an estimated
expenditure for a claim which he or she determines is inaccurate or inadequate.
A revision will be made only after the association has been notified in writing
and given an opportunity to object to the revision.

3. A reserve for reopened claims will be
calculated by the Division of Insurance based upon a percentage of the actual
expenses paid on all closed claims. The percentage will be based upon the
following sliding scale according to the number of uninterrupted years the
association has been in a program of self-insurance:

(a) Inception to 5 years in the program, 3 percent;

(b) Six to 10 years in the program, 2 percent;

(c) Eleven to 15 years in the program, 1 percent;
and

(d) More than 15 years in the program, 0.5 percent.

4. The number of years an association has
been self-insured will be based upon the State’s fiscal year beginning July 1
and ending June 30. If the date of certification is on or before December 31, a
full year will be calculated for the first year of certification. If the date
of certification is January 1 or after, the beginning year of certification
will not be counted. The number of uninterrupted years an association has been
self-insured will be calculated from the last date on which it was certified.

1. An association shall submit to the
Commissioner a report on any injury or disease expected to result in the
payment of at least $100,000 for medical costs or indemnity or to trigger the
need for excess insurance coverage. The report must be submitted within 30 days
after the actual occurrence of the claim or the projection of the reserve, and
must contain:

(a) The name of the claimant and the date and type
of injury;

(b) The amount paid to date for medical costs and
indemnity;

(c) The projected amount of reserves that have been
established; and

(d) The amount paid, or anticipated to be paid, by
excess insurance.

2. An association shall submit to the
Commissioner a report on any accident which is fatal to one or more employees
or results in the hospitalization of five or more employees. The report must be
submitted within 30 days after the actual occurrence, and must contain:

(a) The names of the claimants and the dates and
types of injuries;

(b) The amount paid to date for medical costs and
indemnity;

(c) The projected amounts of reserves that have
been established; and

(d) The amount anticipated to be paid by excess
insurance.

3. The Commissioner may withdraw the
certification of an association that fails timely to submit the reports
required by subsections 1 and 2.

(Added to NAC by Comm’r of Insurance, eff. 3-22-96; A
by R112-04, 8-25-2004)

1. Except as otherwise provided in
subsection 10, an association may purchase an annuity payable to an employee
who has filed a claim pursuant to chapters
616A to 617, inclusive, of NRS, or
to the employee’s beneficiary, for the compensation owed to the employee as a
result of an industrial injury or occupational disease, except accident
benefits, if:

(a) The annuity is
purchased from an insurer authorized to do business in this State;

(b) The employee or the beneficiary is the
annuitant and all payments made pursuant to the annuity will be made directly
to the employee or the beneficiary; and

(c) The purchase of the annuity by the association
on behalf of the employee is made to provide compensation owed to the employee
or the beneficiary pursuant to chapters
616A to 617, inclusive, of NRS.

2. The purchase of an annuity pursuant to
this section does not:

(a) Settle the employee’s claim for compensation;

(b) Prohibit the employee from reopening or
contesting the claim; or

(c) Transfer the responsibility of the association
to provide, in a timely manner, accurate payments of compensation owed to the
employee to the insurer or any other party.

3. Each contract for an annuity purchased
pursuant to this section must set forth the provisions of subsections 1 and 2.

4. An annuity purchased pursuant to this
section may not be assigned.

5. An association which purchases an annuity
pursuant to this section shall make all payments required for the purchase of
the annuity.

6. The amount of the total payments made to
an employee pursuant to an annuity purchased pursuant to this section may not
be less than the amount of compensation, other than accident benefits, owed to
the employee pursuant to chapters 616A
to 617, inclusive, of NRS.

7. An association which purchases an annuity
pursuant to this section:

(a) Shall classify the purchase of the annuity as
an amount paid for indemnity; and

(b) May reduce its reserve balance for indemnity
for the claim by the amount of compensation owed to the employee pursuant to chapters 616A to 617, inclusive, of NRS for the period
covered by the annuity.

8. An association shall submit to the
Commissioner, with the annual report required by NAC
616B.564, a list which sets forth each annuity it purchased, if any, in the
preceding year. The self-insured employer shall provide the following
information for each annuity listed in the report:

(a) The name of the employee on whose behalf the
annuity was purchased;

(b) The number assigned to the claim by the
association;

(c) The number of the contract for the annuity;

(d) The amount paid for the annuity; and

(e) The name of the insurer who issued the annuity.

9. An insurer who sells an annuity to an
association shall, within 10 days after the contract for the annuity is
executed, submit a copy of that contract to the Commissioner and the
association.

10. An association may, upon the approval of
the Commissioner, purchase an annuity to pay the accident benefits of an
employee incurred as a result of an industrial injury or occupational disease.

1. After the withdrawal of a certificate,
the Commissioner and Administrator retain jurisdiction over injuries sustained
during the period of self-insurance until all liabilities and all
responsibilities have terminated.

2. The Commissioner and Administrator will
require an association whose certificate has been withdrawn to provide any
necessary reports setting forth the status of all compensable cases which
remain open.

3. The Commissioner and Administrator will
audit the compensable claims of an association whose certificate has been
withdrawn, and the members of the association shall pay the expenses incurred
by the Commissioner and Administrator, or a representative of either of them,
in conducting the audits.

(Added to NAC by Div. of Industrial Relations by R112-98,
eff. 12-18-98)

1. Except as otherwise provided in
subsection 3, an association shall pay to the Commissioner for deposit in the
Account for Insolvent Associations of Self-Insured Public or Private Employers
an annual assessment equal to 0.5 percent of the amount of the security that it
is required to have on deposit pursuant to NRS 616B.353 on June 30 next
preceding the date on which the assessment is due.

2. At least 20 days before the assessment is
due, the Commissioner will notify the association, by regular mail, of its
obligation to pay the assessment pursuant to subsection 1. The notice will
include:

(a) The amount of money the association must pay;
and

(b) The date on which the assessment is due.

3. The Commissioner will not collect the
annual assessment from an association:

(a) For the fiscal year in which the association is
first issued its certification; or

(b) If the balance of the Account for Insolvent
Associations of Self-Insured Public or Private Employers exceeds:

(1) Three million dollars; or

(2) An amount equal to 20 percent of the
aggregate amount of the security required to be deposited by all certified
associations pursuant to NRS
616B.353,

1. Except as otherwise provided in
subsection 4, if the Commissioner determines that the balance in the Account
for Insolvent Associations of Self-Insured Public or Private Employers is not
sufficient to pay compensation that is due pursuant to chapters 616A to 617, inclusive, of NRS on behalf of an
insolvent association or if an insolvent association or its surety fails to
reimburse the Account pursuant to NAC 616B.582,
the Commissioner will collect an additional assessment from all certified
associations. The additional assessment will be in an amount calculated to pay
all compensation that is due pursuant to chapters
616A to 617, inclusive, of NRS or
to reimburse the Account for Insolvent Associations of Self-Insured Public or
Private Employers.

2. At least 20 days before the additional
assessment is due, the Commissioner will notify each association, by regular
mail, of its obligation to pay the additional assessment pursuant to subsection
1. The notice will include:

(a) The amount of money the association must pay;
and

(b) The date on which the additional assessment is
due.

3. For the purposes of NRS 616B.428, the failure of an
association timely to pay the additional assessment pursuant to this section is
prima facie evidence that the association intentionally failed to comply with a
provision of a regulation adopted by the Commissioner pursuant to chapters 616A to 616D, inclusive, of NRS.

4. If:

(a) The Account for Insolvent Associations of
Self-Insured Public or Private Employers has been used to pay the claims of an
insolvent association;

(b) That association fails to reimburse the Account
for Insolvent Associations of Self-Insured Public or Private Employers; and

(c) The Commissioner determines that the balance of
the Account for Insolvent Associations of Self-Insured Public or Private
Employers is sufficient to pay compensation that is due pursuant to chapters 616A to 617, inclusive, of NRS on behalf of other
insolvent associations,

Ê the
Commissioner may decide not to impose an assessment pursuant to this section against
associations certified on that date.

(Added to NAC by Comm’r of Insurance, eff. 3-22-96; A
by R139-99, 1-27-2000)

1. If an association fails to pay any
compensation due under chapters 616A
to 617, inclusive, of NRS because it
is insolvent, the Commissioner may use the money in the Account for Insolvent
Associations of Self-Insured Public or Private Employers to:

(a) Pay the compensation that is due; or

(b) Retain experts and administrators to assume,
under the direction of the Commissioner, the responsibility for the
administration of the claim and the payment of the compensation that is due.

2. The payment of compensation from the
Account for Insolvent Associations of Self-Insured Public or Private Employers
and of the administrative costs associated with that payment does not limit or
terminate the responsibility of the association, the members of the association
or any surety providing a surety bond for the association to pay any
compensation due pursuant to chapters
616A to 617, inclusive, of NRS.
The association or its surety shall reimburse the Account for Insolvent
Associations of Self-Insured Public or Private Employers for all expenses
incurred in the payment of the compensation.

1. During its first 2 years of operation, an
association shall submit to the Commissioner a quarterly report concerning the
losses of the association. The report must contain a statement of the number of
open claims, the amount of reserves established for the medical and indemnity payments
on the open claims, the amount paid to date for medical and indemnity payments
on the open claims, the number of closed claims and the actual amounts paid for
medical and indemnity payments on the closed claims. After an association has
completed 2 years of operation, it shall submit the reports on a semiannual
basis.

2. During its first 2 years of operation, an
association shall submit a quarterly financial statement concerning the
association. After an association has completed 2 years of operation, it shall
submit the reports on a semiannual basis.

(Added to NAC by Comm’r of Insurance, eff. 3-22-96)

NAC 616B.591Examinations and audits. (NRS 616B.395, 616B.410, 616B.446, 679B.130)The
Commissioner may contract with a person to conduct the examinations and audits
of associations required by NRS
616B.395 and 616B.410,
respectively. The person appointed shall conduct the examinations and audits in
accordance with the provisions of the Financial Examiners Handbook
published by the National Association of Insurance Commissioners and may
consult additional resources as needed, but in case of conflict shall follow
the provisions of the Financial Examiners Handbook.

(Added to NAC by Comm’r of Insurance, eff. 3-22-96)

NAC 616B.594Calculation of annual assessment paid by each member of
association. (NRS
616B.353, 616B.407, 616B.446, 679B.130)If an
association has received approval from the Commissioner pursuant to subsection
2 of NRS 616B.407 to calculate
the annual assessment required to be paid by each member of the association, it
may use the rates and classifications, including experience modification
factors, established by the advisory organization.

(Added to NAC by Comm’r of Insurance, eff. 3-22-96; A
by R139-99, 1-27-2000)

NAC 616B.597Responsibilities of board of trustees; financial condition of
association; financial condition of member. (NRS 616B.365, 616B.446, 679B.130)In the
performance of their duties, the members of the board of trustees of an
association are fiduciaries to the association and are responsible for
communicating all information regarding the association to its members,
including, without limitation, the financial condition of the association and
the loss experience of the members of the association. The board of trustees
shall not withhold material information concerning losses or material
information concerning the financial condition of the association from the
members of the association and shall promptly disclose such information to any
member upon request. If the financial condition of a member fails to comply
with the financial requirements established by law, the bylaws of the
association or the underwriting plan of the association, the association must
immediately disclose such fact to the other members.

(Added to NAC by Comm’r of Insurance, eff. 3-22-96)

NAC 616B.598Requests for approval of declaration of dividend and for approval
of distribution of dividend. (NRS 616B.446, 679B.130)

1. An association must submit a request for
approval of a declaration of a dividend to the Commissioner not less than 30
days before the proposed date of the declaration of the dividend.

2. An association must submit a request for
approval of a distribution of a dividend to the Commissioner not less than 30
days before the proposed date of the distribution of the dividend.

3. A request for approval of a distribution
of a dividend submitted by an association pursuant to subsection 2 must
include:

(a) An actuarial analysis of loss reserves that was
prepared by a member of the American Academy of Actuaries not more than 90 days
before the date that the request is submitted pursuant to subsection 2;

(b) An analysis of the assets and obligations of
the association by fund year that was prepared by the association on a form
approved by the Commissioner and includes a detail of the unrealized gains and
losses of the association;

(c) The proposed date of the distribution of the
dividend;

(d) The amount of the dividend by fund year;

(e) A copy of the most recent financial statements
of the association;

(f) Any other information or report that the
Commissioner determines to be necessary to evaluate the request; and

(g) If an association has a deficit in any fund
year, a plan for making up the deficit of the association that meets the
requirements of NRS 616B.422.

4. As used in this section:

(a) “Dividend” means any distribution of earnings
or retained earnings, in the form of money or property, from an association to
the members of the association.

(b) “Fund year” means the fiscal year used by an
association for the purposes of financial reporting.

1. Invoke the provisions of the indemnity
agreement executed by each member of the association;

2. Use the security deposit of the
association;

3. Use any solvency bonds deposited with him
or her by or on behalf of the association; and

4. Use the Account for Insolvent
Associations of Self-Insured Public or Private Employers,

Ê to pay claims
and related expenses.

(Added to NAC by Comm’r of Insurance, eff. 3-22-96; A
by R139-99, 1-27-2000)

NAC 616B.603Determination and consideration of loss ratio. (NRS 616A.400, 616B.386, 616B.446, 679B.130)Except
as otherwise provided in this section, an employer with a loss ratio of 115
percent or higher under any program or contract of insurance for workers’
compensation may not join an association. The Commissioner may allow an
employer with a loss ratio higher than 115 percent to join an association if
the employer demonstrates to the Commissioner that its loss ratio is the result
of an unusual circumstance, such as a single loss, a claim that should have
been subrogated or a claim that should have been submitted to a Subsequent Injury
Account. The Commissioner will determine the loss ratio of a prospective member
of an association by taking the average of the loss ratios of the prospective
member for the 3 most recent fiscal years ending not less than 1 year before
the date of application by the prospective member.

(Added to NAC by Comm’r of Insurance, eff. 3-22-96; A
by Div. of Industrial Relations by R112-98, 12-18-98)

NAC 616B.606Adoption of certain publications by reference. (NRS 616B.446, 679B.130)The
Commissioner hereby adopts by reference the Property/Casualty Insurance
Annual Statement Blanks and the Annual Statement Instructions for the
Property/Casualty Manual of the National Association of Insurance
Commissioners. A copy of these publications may be purchased from NAIC
Publications Customer Service, 2301 McGee Street, Suite 800, Kansas City,
Missouri 64108-2662, for $200 and $225, respectively.

(Added to NAC by Comm’r of Insurance, eff. 3-22-96; A
by R063-06, 6-28-2006)

1. The audited statement of the financial
condition of an association required by NRS 616B.404 must be:

(a) Prepared in accordance with generally accepted
accounting principles of the United States, stated in United States dollars,
and must contain the footnotes and opinions of the independent certified public
accountant who prepared it.

(b) Accompanied by a statement, prepared by the
independent certified public accountant who prepared the audited statement,
certifying that the combined tangible net worth of all members of the
association satisfies the requirements of NRS 616B.353 and that all members
meet the financial requirements for membership that are established by law, the
bylaws of the association or the underwriting plan of the association.

2. In addition to the statements and
schedules required by law, the association shall submit the following exhibits
and schedules from the Annual Statement Blanks for Property/Casualty
published by the National Association of Insurance Commissioners:

1. Copies of the association’s last three
audited statements of financial condition submitted pursuant to NRS 616B.404; and

2. Any additional information or documents
requested in writing by the Commissioner.

(Added to NAC by Comm’r of Insurance by R119-07, eff.
12-4-2007)

NAC 616B.612Contents of bylaws of association. (NRS 616B.446, 679B.130)The
bylaws of an association must provide:

1. For review by the board of trustees, at
least annually, of the financial condition of each member of the association;

2. For prompt notification to all members if
the board of trustees has determined that any member is operating in a
hazardous financial condition;

3. For review by the members, at least
annually, of the loss experience of each member of the association; and

4. A plan for the cancellation of membership,
pursuant to subsection 9 of NRS
616B.386, of members who have an excessive loss experience or who have been
deemed by the board of trustees to be operating in a hazardous financial
condition.

1. Except as otherwise provided in
subsection 2, an insurer shall file with the Commissioner for approval each
form for a policy of industrial insurance that the insurer intends to use and
any modification to such a form. If the Commissioner does not disapprove a form
or a modification to a form within 60 days after it has been filed, the form or
modification to the form shall be deemed approved.

2. An insurer may modify a form for a policy
of industrial insurance without filing the modified form with the Commissioner
pursuant to subsection 1 if:

(a) The insurer uses a form for a policy of
industrial insurance that was filed by the Advisory Organization pursuant to NRS 686B.1765 and approved by
the Commissioner;

(b) The modification to the form and any use of the
form are consistent with the manual of rules that was filed by the Advisory
Organization pursuant to NRS
686B.1765 and approved by the Commissioner; and

(c) The modification is limited to:

(1) The inclusion of the name or logo of the
insurer on the form; or

(2) The format of the form, including, without
limitation, the size of the type used on the form.

3. As used in this section, “Advisory
Organization” has the meaning ascribed to it in NRS 686B.1752.

(Added to NAC by Comm’r of Insurance by R111-98, 3-12-99,
eff. 7-1-99)

NAC 616B.622Policy of industrial insurance: Use of policy. (NRS 616B.030, 679B.130)Each
private carrier shall use the basic policy of industrial insurance prescribed
by the Commissioner pursuant to NRS
616B.030.

(Added to NAC by Comm’r of Insurance by R111-98, 3-12-99,
eff. 7-1-99)

NAC 616B.623Policy of industrial insurance: Determination of unearned or
earned premium when policy cancelled before anniversary date or written for
less than 12 months. (NRS 616B.030, 679B.130)

1. To determine the unearned premium that
must be returned to an employer or the earned premium that must be paid to the
insurer, as appropriate, when a policy of industrial insurance is cancelled
before the anniversary date of the policy or written for a term of less than 12
months:

(a) The limitation of $36,000 established pursuant
to NRS 616B.222 on the amount
an employee is deemed to have received for services performed during the year
in which a policy of industrial insurance is effective shall be deemed to be
earned by that employee in increments of $3,000 per month and, if the policy
includes a period of less than a month, in daily increments of an amount that
represents a proportionate distribution of $3,000 over a month.

(b) Payment that is not received by an employee in
even increments throughout the year in which the policy is effective shall be
deemed to be paid in accordance with the rating rule for bonuses filed by the
advisory organization with the Commissioner pursuant to NRS 686B.177.

2. As used in this section, “advisory
organization” has the meaning ascribed to it in NRS 686B.1752.

1. Except as otherwise provided in
subsection 2, to obtain approval as an organization or association of employers
as a group pursuant to NRS
616B.036, the organization or association must file with the Commissioner
or a designated representative thereof:

(a) A copy of the agreement of the organization or
association which has been certified by the custodian of the original
agreement; and

(b) A written statement from the organization or
association that describes the safety committee that the organization or
association will establish and maintain to reduce the incidence and severity of
accidents by carrying out a program to control losses and provide information
on the prevention of accidents.

2. A private carrier may make the filing
required pursuant to subsection 1 on behalf of the organization or association
if the filing is accompanied by a power of attorney executed by the organization
or association authorizing the private carrier to make such a filing on its
behalf.

(Added to NAC by Comm’r of Insurance by R111-98, 3-12-99,
eff. 7-1-99)

NAC 616B.626Combining experience for certain purposes. (NRS 679B.130)A
private carrier may combine the experience of the members of an organization or
association of employers as a group for which the private carrier provides
industrial insurance for the purposes of:

1. Paying dividends to the members; or

2. Determining premiums pursuant to a plan
for retrospective rating if the plan has been filed with and approved by the
Commissioner.

(Added to NAC by Comm’r of Insurance by R111-98, 3-12-99,
eff. 7-1-99)

1. For assessments for fiscal years before
fiscal year 1999-2000, the total amount of money actually paid for compensation
in a fiscal year, including those costs of claims covered under a policy of
reinsurance or a policy of excess insurance, by or on behalf of an insurer
pursuant to chapters 616A to 617, inclusive, of NRS, reduced by any
amount received from subrogation and reimbursement from the Subsequent Injury
Account of the insurer.

2. For assessments for fiscal year 1999-2000
and for each subsequent fiscal year, the total amount of money actually paid
for compensation in a fiscal year for injuries occurring on or after July 1,
1999, including those costs of claims covered under a policy of reinsurance or
a policy of excess insurance, by an insurer or its third-party administrator
pursuant to chapters 616A to 617, inclusive, of NRS, reduced by any
amount received from subrogation and reimbursement from the Subsequent Injury
Account of the insurer.

(Added to NAC by Dep’t of Industrial Relations, eff. 8-26-83;
A 7-29-87; A by Div. of Industrial Relations by R112-98, 12-18-98; R096-99, 11-29-99)

NAC 616B.689“Expected annual disbursements” defined. (NRS 232.680, 616A.400)“Expected
annual disbursements” means an estimate of the sum of all payments to be made
for compensation in a fiscal year from:

1. The Uninsured Employers’ Claim Account;
and

2. The Subsequent Injury Accounts.

(Added to NAC by Dep’t of Industrial Relations, eff. 8-26-83;
A by Div. of Industrial Relations by R112-98, 12-18-98)

NAC 616B.692“Expected annual expenditures for claims” defined. (NRS 232.680, 616A.400)“Expected
annual expenditures for claims” means an estimate of the total amount of money
to be paid for compensation in a fiscal year for injuries occurring on or after
July 1, 1999, including those costs of claims covered under a policy of
reinsurance or a policy of excess insurance, by an insurer or its third-party
administrator pursuant to chapters 616A
to 617, inclusive, of NRS.

(Added to NAC by Dep’t of Industrial Relations, eff. 8-26-83;
A by Div. of Industrial Relations by R096-99, 11-29-99)

(Added to NAC by Dep’t of Industrial Relations, eff. 8-30-91;
A by Div. of Industrial Relations by R096-99, 11-29-99; R096-99, 11-29-99, eff.
1-1-2000)

NAC 616B.698“Program of self-insurance” defined. (NRS 232.680, 616A.400)“Program
of self-insurance” means the program established pursuant to chapters 616A to 617, inclusive, of NRS for which an
employer is issued a certificate of qualification as a self-insured employer or
an association of self-insured employers by the Commissioner.

(Added to NAC by Dep’t of Industrial Relations, eff. 8-26-83;
A by Div. of Industrial Relations by R112-98, 12-18-98)

NAC 616B.701Estimated annual assessment. (NRS 232.680, 616A.400)The
Division will determine the estimated annual assessment to be made against each
insurer in order to defray the:

1. Costs and expenses of administering the
program of workers’ compensation and safety; and

2. Amount of the expected annual
disbursements to be made from the Uninsured Employers’ Claim Account and the
Subsequent Injury Account of the insurer.

(Added to NAC by Dep’t of Industrial Relations, eff. 8-26-83;
A by Div. of Industrial Relations by R112-98, 12-18-98)

2. The Division may require an insurer to
provide a copy of any cancelled check described in subsection 1. Within 15 days
after the insurer receives a written request from the Division, the insurer
shall provide a copy of both sides of each cancelled check requested. The
Division may require the insurer to provide a certified copy of each cancelled
check requested.

3. Each insurer shall provide the Division,
at such times and in the form and manner prescribed by the Division, with
reports of expected annual expenditures for claims, annual expenditures for
claims and such other information as the Division deems necessary to calculate
an estimated or final annual assessment. Each report of expenditures for claims
must identify expenditures attributable to claims made by persons who were
employed by the operators of mines at the time of their injuries.

4. The Division will provide to each insurer
an annual report showing the figures and sources used in calculating the
estimated annual expenditures for claims.

(Added to NAC by Dep’t of Industrial Relations, eff. 8-26-83;
A 7-29-87; 8-30-91; A by Div. of Industrial Relations by R112-98, 12-18-98)

NAC 616B.707Consideration of expenditures as expenditures for claims;
computation and reporting of value of clinical services. (NRS 232.680, 616A.400)

1. The Division will consider expenditures
for the following as expenditures for claims:

(2) Reviewing any report of a physician or
chiropractor contained in a file relating to a claim; or

(3) Services relating to the management of
costs of medical care.

(g) Costs incurred in a claim that is ultimately
denied.

3. The value of clinical services furnished
by an insurer for industrial injuries or illnesses must be computed and
reported pursuant to the schedule of fees and charges for accident benefits
adopted pursuant to subsection 2 of NRS
616C.260.

(Added to NAC by Dep’t of Industrial Relations, eff. 7-29-87;
A 8-30-91; A by Div. of Industrial Relations, 3-28-94; R112-98, 12-18-98; R118-02,
9-7-2005)

NAC 616B.710Calculating annual expenditures for claims. (NRS 232.680, 616A.400)In
calculating his or her annual expenditures for claims, an insurer shall:

1. Reduce the expenditures for claims by an
amount equal to the amount of money received from subrogation or reimbursement
from the insurer’s Subsequent Injury Account in the fiscal year in which it is
received; and

2. Not reduce the total amount of money
actually paid for compensation to an amount less than zero.

(Added to NAC by Dep’t of Industrial Relations, eff. 7-29-87;
A by Div. of Industrial Relations by R112-98, 12-18-98)

NAC 616B.713Statement of amount of expenditures for claims; amount to be used
as source for determining annual expenditures for claims. (NRS 232.680, 616A.400)

1. Except as otherwise provided in NAC 616B.7755, an insurer shall provide to the
Division a statement showing the amount of expenditures for claims described in
NAC 616B.707 for a period designated by the
Division.

2. The statement must be verified and signed
by a responsible person employed by the insurer or an authorized agent thereof.

3. Amounts reported to the Division pursuant
to subsection 1 will be used as the source for determining annual expenditures
for claims.

(Added to NAC by Dep’t of Industrial Relations, eff. 8-26-83;
A 7-29-87; A by Div. of Industrial Relations by R112-98, 12-18-98; R096-99, 11-29-99)

NAC 616B.716Estimate of annual expenditures for claims. (NRS 232.680, 616A.400)If the
amount of annual expenditures for claims paid by any insurer is not provided to
the Division within the required time, the Division will estimate that amount
in order to calculate the assessment to be made against the insurer. The
estimate will be based upon the insurer’s previous history of expenditures for
claims or other available data.

(Added to NAC by Dep’t of Industrial Relations, eff. 8-26-83)—(Substituted
in revision for NAC 616.5451)

1. Except as otherwise provided in NAC 616B.7761, the amount of the expected annual
expenditures for claims of an insurer is the annualized average of his or her
expenditures for claims made during the 3 previous calendar years, unless
estimated by the Division pursuant to NAC 616B.716.

2. For the purposes of this section, the
annualized average will be calculated by dividing the total expenditures for
claims for the 3 previous calendar years by the number of years, or portion
thereof, for which claims are reported.

(Added to NAC by Dep’t of Industrial Relations, eff. 8-26-83;
A by Div. of Industrial Relations by R096-99, 11-29-99)

1. The amount of the estimated annual
assessment made against each insurer to be used to defray:

(a) The administrative costs of the office of the
Administrator, office of Legal Counsel, Administrative Services Unit and
Workers’ Compensation Section will be calculated by multiplying the insurer’s
percentage of expenditures by the amount approved in the state budget for those
administrative costs.

(b) The administrative costs of the offices of the Hearings
Division of the Department of Administration and the Nevada Attorney for
Injured Workers for the time spent concerning claims for workers’ compensation
will be calculated by multiplying the insurer’s percentage of expenditures by
the amount approved in the state budget for these administrative costs.

(c) The administrative costs of the Occupational
Safety and Health Administration and the Safety Consultation and Training
Section will be calculated by multiplying the insurer’s percentage of
expenditures by the amount approved in the state budget for those offices.

(d) The administrative costs of the Mine Safety and
Training Section will be calculated by multiplying the insurer’s percentage of
expenditures by the amount approved in the state budget for the Mine Safety and
Training Section.

(e) The costs of the Commissioner for administering
the program of self-insurance will be calculated by multiplying the percentage
of expenditures of each self-insured employer and the percentage of
expenditures of each association of self-insured public or private employers by
the amount approved in the state budget for those costs.

(f) That portion of the cost of the Office for
Consumer Health Assistance that is related to providing assistance to injured
employees concerning workers’ compensation will be calculated by multiplying
the insurer’s percentage of expenditures by the amount approved in the state
budget for that cost.

(g) The administrative costs of the administration
of claims against uninsured employers arising from compliance with NRS 616C.220 will be calculated
by multiplying the insurer’s percentage of expenditures by the amount derived
by multiplying:

(1) The expected annual disbursements to be
made from the Uninsured Employers’ Claim Account; and

(2) The charge for the administration of
claims.

(h) The administrative costs of having premium
rates reviewed by the Commissioner will be calculated by multiplying the
insurer’s percentage of expenditures by the amount approved in the state budget
for those administrative costs.

(i) The amount of disbursements from the Uninsured
Employers’ Claim Account will be calculated by multiplying the insurer’s
percentage of expenditures by the sum of expected annual disbursements to be
made from the Account.

(j) The amount of disbursements from the Subsequent
Injury Accounts for Self-Insured Employers and Private Carriers will be
calculated by multiplying the insurer’s percentage of expenditures by the sum
of expected annual disbursements to be made from the Subsequent Injury Accounts
for Self-Insured Employers and Private Carriers.

2. For the purposes of this section,
“percentage of expenditures” means the proportion of an insurer’s expected
annual expenditures for claims relative to the amount of the expected annual
expenditures for claims of all insurers responsible for the cost shown in a
particular category of the state budget.

(Added to NAC by Dep’t of Industrial Relations, eff. 8-26-83;
A 8-30-91; A by Div. of Industrial Relations by R112-98, 12-18-98; R096-99, 11-29-99;
R108-09, 6-30-2010)

1. If the ownership of property is
transferred from one self-insured employer or association to another, or if a
self-insured employer or association acquires ownership in a property for which
workers’ compensation insurance is provided by a private carrier, the Division
will transfer data relating to annual expenditures for claims for that property
to the new owner within 30 days after receiving notification of the transfer of
ownership, and the Division will recompute the estimated annual assessments for
the insurers only if it finds the existence of a special circumstance
justifying the recomputation.

2. If a self-insured employer elects to give
up his or her status as a self-insured employer and to be insured against
liability for workers’ compensation by a private carrier, the Division will
recompute the estimated annual assessment for all insurers only if it finds the
existence of a special circumstance justifying the recomputation.

3. If an association elects to give up its
status as an association and its members elect to be insured against liability
for workers’ compensation by a private carrier, the Division will recompute the
estimated annual assessment for all insurers only if it finds the existence of
a special circumstance justifying the recomputation.

(Added to NAC by Dep’t of Industrial Relations, eff. 8-26-83;
A by Div. of Industrial Relations by R112-98, 12-18-98; R112-98, 12-18-98, eff.
7-1-99)

1. The Division will issue to each insurer a
statement of his or her estimated annual assessment. The statement must include
the date on which the entire amount is due, or, if the insurer elects to pay
the assessment in quarterly payments, the amounts and dates on which the payments
are due. The Division shall send the statement by mail not less than 30 days
before the date on which payment is due.

2. The
Division shall not require a quarterly payment more than 30 days before the
first day of that quarterly period.

3. Additional assessments to preserve the
solvency of:

(a) The Fund for Workers’ Compensation and Safety;

(b) The Uninsured Employers’ Claim Account; and

(c) The Subsequent Injury Accounts,

Ê may be issued
by the Division.

4. An insurer shall pay the assessment in
full to the Division pursuant to the date established in subsection 1 or pay
the quarterly assessment amounts pursuant to the dates established in
subsection 1.

(Added to NAC by Dep’t of Industrial Relations, eff. 8-26-83;
A 7-29-87; A by Div. of Industrial Relations by R112-98, 12-18-98)

NAC 616B.734Calculation of final assessment; issuance of statement of
assessment. (NRS
232.680, 616A.400)

1. The Division will determine, on the basis
of reports issued by the State Controller for the previous fiscal year relating
to closing budgets and final trial balances, the amount of money disbursed from
and deposited in:

2. Except as otherwise provided in NAC 616B.7767, the Division will calculate, in the
same manner as for estimated annual assessments, the final annual assessment
for each insurer for the previous fiscal year and will use:

(a) The insurer’s statements relating to annual
expenditures for claims for the previous fiscal year submitted pursuant to NAC 616B.713; and

(b) The determinations made pursuant to subsection
1.

Ê The Division
will issue to the insurer a statement of the final assessment.

1. The Administrator will return to an
insurer any excess amount of the final annual assessment paid by the insurer
for the Fund for Workers’ Compensation and Safety or a Subsequent Injury
Account.

2. If an insurer’s final annual assessment
for any fund or account is greater than the estimated annual assessment paid by
the insurer during the previous fiscal year, the insurer shall pay the deficit
to the Division within 30 days after the date of receipt of any statement of
deficit. The payment must be deposited in the appropriate Fund or Account.

(Added to NAC by Dep’t of Industrial Relations, eff. 8-26-83;
A by Div. of Industrial Relations by R112-98, 12-18-98)

NAC 616B.740Penalty for late payment. (NRS 232.680, 616A.400)Except
as otherwise provided in NAC 616B.7758 and 616B.7767, the Division may assess a penalty for the
late payment, without good cause, of an assessment for the Fund for Workers’
Compensation and Safety, the Subsequent Injury Accounts for Self-Insured
Employers or Private Carriers or the Uninsured Employers’ Claim Account in
accordance with the provisions of NRS
616D.120.

(Added to NAC by Dep’t of Industrial Relations, eff. 8-26-83;
A by Div. of Industrial Relations by R112-98, 12-18-98; R096-99, 11-29-99)

1. The Administrator will not consider the
following expenditures to be expenditures for claims for which a private
carrier may receive reimbursement from the Subsequent Injury Account for
Private Carriers:

(a) Amounts held in reserve for any anticipated
expense in connection with a claim.

(b) Money paid in excess of the compensation
calculated pursuant to NRS
616C.440, 616C.475, 616C.490 or 616C.500 or NAC 616C.577 for a temporary total,
temporary partial, permanent total or permanent partial disability or
vocational rehabilitation maintenance.

(2) Reviewing any report of a physician or
chiropractor contained in a file relating to a claim; or

(3) Services relating to the management of
costs of medical care.

(f) Costs incurred in a claim that is ultimately
denied.

2. The value of accident benefits furnished
by a private carrier for industrial injuries or illnesses must be computed and
reported pursuant to the schedule of fees and charges for accident benefits
adopted pursuant to subsection 2 of NRS
616C.260.

(Added to NAC by Div. of Industrial Relations by R112-98,
12-18-98, eff. 7-1-99; A by R118-02, 9-7-2005)

1. The Administrator will examine a claim
against the Subsequent Injury Account for Private Carriers and not later than
90 days after receipt of the claim will:

(a) Notify the private carrier that a determination
on the claim cannot be made and the reasons therefor; or

(b) Notify the private carrier of the acceptance or
denial of the claim; and

(c) If the claim is accepted, notify the private
carrier of the verified amount of reimbursement and that the claim will be
processed for payment by the State Controller.

2. An appeal
from a determination of the Administrator concerning a claim against the
Subsequent Injury Account for Private Carriers must be made in writing and sent
directly to the appeals officer within 30 days after the date of the
Administrator’s determination.

(Added to NAC by Div. of Industrial Relations by R112-98,
12-18-98, eff. 7-1-99)

1. A claim against the Subsequent Injury
Account for Self-Insured Employers established pursuant to NRS 616B.554 must be submitted in
writing to the Administrator for evaluation by the Board.

2. A self-insured employer who submits a
claim pursuant to subsection 1 shall include with the claim:

(a) The information necessary to establish that the
claim should be paid from the Subsequent Injury Account for Self-Insured
Employers, including the medical records of the employee who is the subject of
the claim; and

(b) A completed copy of the form entitled “D-37,
Insurer’s Subsequent Injury Checklist” which is prescribed by the
Administrator. A copy of the form may be obtained from the Administrator at no
cost.

3. A claim submitted to the Administrator
pursuant to subsection 1 must be organized in the manner prescribed in part 5
of Form D-37, Insurer’s Subsequent Injury Checklist.

4. A self-insured employer who submits a
claim pursuant to subsection 1 shall, upon the request of the Administrator:

(a) Allow the Administrator to inspect the records
maintained by the self-insured employer concerning the claim; or

1. If the Board denies a claim or any of the
expenses related to the claim, the self-insured employer who submitted the
claim may request a hearing before the Board by filing a written request with
the Board’s legal counsel within 30 days after the Board’s attorney notifies
the self-insured employer of the decision of the Board.

2. The Board will conduct the hearing within
45 days after the request for a hearing is filed with the Board’s legal counsel
unless the Board grants a continuance. The Board may grant a continuance upon
its own motion or, for good cause shown, upon the request of the Administrator
or the self-insured employer who submitted the claim.

1. If, after conducting a hearing pursuant
to NAC 616B.7706, the Board denies a claim or any
of the expenses related to the claim, the Board will:

(a) Direct the legal counsel for the Board to
prepare a written order which sets forth the decision of the Board and includes
findings of fact and conclusions of law; and

(b) Deliver to the Board and the self-insured
employer who submitted the claim or a representative thereof a copy of the
order of the Board.

2. A self-insured employer may, within 10 days
after receiving the order of the Board, file with the Board’s legal counsel
objections to the findings of fact or conclusions of law.

(Added to NAC by Div. of Industrial Relations, eff. 2-18-97)

NAC 616B.7712Representation by legal counsel at hearing. (NRS 616A.400, 616B.554, 616B.557)The
Administrator and the Board may be represented by legal counsel at a hearing
conducted pursuant to NAC 616B.7706. A
self-insured employer may be represented before the Board by a representative of
his or her choice.

(Added to NAC by Div. of Industrial Relations, eff. 2-18-97)

NAC 616B.7714Withdrawal from proceeding by member of Board. (NRS 616A.400, 616B.554, 616B.557)A member
of the Board may withdraw from a proceeding whenever the member considers
himself or herself to be disqualified.

(Added to NAC by Div. of Industrial Relations, eff. 2-18-97)

SUBSEQUENT INJURY ACCOUNT FOR ASSOCIATIONS OF SELF-INSURED
PUBLIC OR PRIVATE EMPLOYERS

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R215-97 & R216-97,
eff. 8-19-99)—(Substituted in revision for NAC 616B.7748)

NAC 616B.7732“Annual disbursements from the Account” defined. (NRS 616B.572, 616B.575)“Annual
disbursements from the Account” means the aggregate sum of all payments for
compensation made from the Account in a fiscal year.

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R216-97, eff. 8-19-99)

NAC 616B.7734“Annual expenditures for claims of an association” defined. (NRS 616B.572, 616B.575)“Annual
expenditures for claims of an association” means the aggregate sum of:

1. All money the association paid for
compensation in a fiscal year pursuant to chapters
616A to 617, inclusive, of NRS
reduced by any money received by the association in that fiscal year from
subrogation and reimbursement from the Account; and

2. Any money the successor organization to
the State Industrial Insurance System paid for compensation in that fiscal year
pursuant to chapters 616A to 617, inclusive, of NRS on behalf of a
public or private employer who is a member of the association if the money was
paid by the successor organization to the State Industrial Insurance System for
claims that were incurred before the public or private employer became a member
of the association.

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R216-97, eff. 8-19-99)

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R216-97, eff. 8-19-99)

NAC 616B.7742“Expected annual disbursements from the Account” defined. (NRS 616B.572, 616B.575)“Expected
annual disbursements from the Account” means an estimate of the annual
disbursements from the Account.

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R216-97, eff. 8-19-99)

NAC 616B.7744“Expected annual expenditures for claims of an association”
defined. (NRS
616B.572, 616B.575)“Expected
annual expenditures for claims of an association” means an estimate of the
annual expenditures for claims of an association.

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R216-97, eff. 8-19-99)

1. Each association shall maintain records
in this State of the annual expenditures for claims of the association. Such
records must include, without limitation:

(a) Copies of all checks that have been issued for
each claim;

(b) A register that documents all checks that have
been issued for each claim and any voided checks related to such claims;

(c) A register that documents any other form of
payment that has been made for each claim; and

(d) Any working papers that the association used to
report annual expenditures for claims of the association.

2. Except as otherwise provided in this
subsection and subsection 3, each association shall provide to the Division, at
such times and in such form and manner as prescribed by the Division:

(a) A report that contains the annual expenditures
for claims and expected annual expenditures for claims of the association;

(b) A report which contains the annual expenditures
for claims of the association, divided into monthly expenditures, and which has
been verified and signed by an authorized employee or agent of the association;
and

(c) Any other information that the Division
determines is necessary to calculate an estimated annual assessment or final
annual assessment for the association.

3. The Division may, by written request,
require an association to provide a copy or certified copy of any check
described in subsection 1. If an association receives such a request, the
association shall provide the Division with a copy or certified copy, as
requested, of both sides of the check not later than 15 days after the date
that the association receives the request.

4. To calculate its annual expenditures for
claims pursuant to this section, an association shall reduce its annual
expenditures for claims made in each fiscal year by the amount of the money the
association received in that fiscal year from subrogation and reimbursement
from the Account.

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R216-97, eff. 8-19-99)

1. The Division shall collect an estimated
annual assessment from each association to defray the expected annual
disbursements from the Account.

2. Except as otherwise provided in subsection
3, to calculate the estimated annual assessment to be collected from each
association, the Division shall:

(a) Calculate the expected annual expenditures for
claims of the association pursuant to NAC 616B.7761
and 616B.7764;

(b) Divide the expected annual expenditures for
claims of the association by the aggregate sum of the expected annual
expenditures for claims of all associations; and

(c) Multiply the result of the calculation
performed pursuant to paragraph (b) by the expected annual disbursements from
the Account as calculated by the Division.

3. If an association does not participate in
a program of self-insurance for the entire fiscal year, the Division shall
collect the estimated annual assessment from the association pursuant to
subsection 2 in the proportion that the number of months of the fiscal year
during which the association participates in a program of self-insurance bears
to the total number of months in the fiscal year.

4. The Division shall mail to each
association a statement of its estimated annual assessment that includes the
date on which the entire amount of the assessment is due. The Division shall
mail the statement to each association:

(a) On or before July 30 of each year; and

(b) Not later than 30 days before the date on which
the entire amount of the assessment is due.

5. If an association does not pay the entire
amount of the estimated annual assessment to the Division within 7 days after
the date on which it is due, the Division shall assess against the association
a penalty of $1,000 for each day that any portion of the estimated annual
assessment remains unpaid, but such a penalty must not exceed $50,000 for each
such unpaid estimated annual assessment.

6. The Administrator may seek recovery of
any unpaid assessments or penalties.

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R216-97, eff. 8-19-99)

1. Except as otherwise provided in
subsection 2, to calculate the expected annual expenditures for claims of an
association, the Division shall:

(a) Calculate the annual expenditures for claims of
the association for each of the immediately preceding 3 calendar years pursuant
to NAC 616B.7764; and

(b) Average the annual expenditures for claims of
the association for those 3 calendar years.

2. If an association does not provide the
Division with its annual expenditures for claims when requested, the Division
shall, in lieu of calculating the expected annual expenditures for claims of
the association pursuant to subsection 1, estimate the annual expenditures for
claims of the association using the previous history of annual expenditures for
claims of the association and any other available data, including, without
limitation, the annual expenditures for claims of each public or private
employer who is a member of the association.

3. The Division shall provide to each
association an annual report showing the figures and sources that were used by
the Division to:

(a) Calculate the expected annual expenditures for
claims of the association pursuant to subsection 1; or

(b) Estimate the annual expenditures for claims of
the association pursuant to subsection 2.

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R216-97, eff. 8-19-99)

1. For the purposes of subsection 1 of NAC 616B.7761, to calculate the annual expenditures
for claims of an association for each of the immediately preceding 3 calendar
years, the Division shall:

(a) Consider the reports and any other information
provided to the Division by the association pursuant to NAC 616B.7755;

(b) Consider the statements obtained from the
successor organization to the State Industrial Insurance System pursuant to
subsection 2; and

(c) Determine which payments made by the
association are to be considered expenditures for claims pursuant to
subsections 3 and 4.

2. For each association, the Division shall
obtain from the successor organization to the State Industrial Insurance System
a statement showing:

(a) The annual expenditures for claims, divided
into monthly expenditures, that were made by each public or private employer in
the association before such employer became a member of the association; and

(b) The annual expenditures for claims, divided
into monthly expenditures, that were made by each public or private employer in
the association after such employer became a member of the association.

3. The Division shall consider money paid by
an association for any of the following to be expenditures for claims:

1. As soon as practicable after the end of a
fiscal year, the Division shall calculate a final annual assessment for each
association for that completed fiscal year.

2. To calculate the final annual assessment
for an association for the completed fiscal year, the Division shall:

(a) Calculate pursuant to NAC
616B.7764 the annual expenditures for claims of the association for the
completed fiscal year based upon the appropriate information obtained from the
association and the successor organization to the State Industrial Insurance
System;

(b) Calculate the amount of money deposited to and
paid from the Account based upon the reports issued by the State Controller for
the completed fiscal year relating to closing budgets and final trial balances;
and

(c) Use the formula set forth in subsection 2 of NAC 616B.7758 to calculate the final annual
assessment for the association by substituting the figures for expected annual
disbursements from the Account and expected annual expenditures for claims with
the appropriate figures for the completed fiscal year for annual disbursements
from the Account and annual expenditures for claims.

3. The Division shall mail to each
association a statement of its final annual assessment for the completed fiscal
year.

4. If the final annual assessment of an
association for a completed fiscal year is less than the estimated annual
assessment that was paid by the association for that fiscal year, the
Administrator shall return to the association the amount of the estimated
annual assessment that exceeded the final annual assessment.

5. If the final annual assessment of an
association for a completed fiscal year is more than the estimated annual
assessment that was paid by the association for that fiscal year, the
association shall pay to the Division the amount of the final annual assessment
that exceeded the estimated annual assessment. The Division shall include with
the statement mailed to the association pursuant to subsection 3 a statement
informing the association of the amount that is due and the date on which it is
due. If the association does not pay the entire amount to the Division within 7
days after the date on which it is due, the Division shall assess against the
association a penalty of $1,000 for each day that any portion of the amount
remains unpaid, but such a penalty must not exceed $50,000 for each such unpaid
amount.

6. The Administrator may seek recovery of
any unpaid assessments or penalties.

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R216-97, eff. 8-19-99)

1. Must be made by personal service or
first-class mail, unless another form of service is otherwise required pursuant
to the provisions of NAC 616B.7781 or 616B.7785; and

2. Shall be deemed to have been made on the
date that the notice or other document is personally served to the person or
his or her personal representative or on the date that the notice or other
document is mailed, whichever date occurs first.

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R215-97, eff. 8-19-99)

1. Except as otherwise provided in NAC 616B.779, the Board will approve or disapprove,
in whole or in part:

(a) Each claim made against the Account by an
association, if the claim is completed by the association pursuant to the
requirements set forth in this section; and

(b) Any expenses of the association related to each
such claim that the Administrator has verified pursuant to the provisions of NAC 616B.707.

2. To submit a claim to the Board, an
association must:

(a) Serve the claim, in writing, to the
Administrator;

(b) Include with the claim a completed copy of the
form entitled “D-37, Insurer’s Subsequent Injury Checklist” that is prescribed
by the Administrator;

(c) Organize the claim in the manner prescribed in
Form D-37 and number each of the pages in the claim sequentially; and

(d) Include with the claim all information which is
necessary to establish that the claim should be paid from the Account. Such
information must include, without limitation, the medical records of the
injured employee who is the subject of the claim.

3. A copy of Form D-37 may be obtained from
the Administrator at no cost.

4. A claim shall be deemed to be complete 15
days after the date that the claim is served to the Administrator pursuant to
subsection 2, unless the Administrator serves notice to the association that
the claim is incomplete pursuant to subsection 6.

5. A claim is incomplete if the claim:

(a) Does not include a completed copy of Form D-37;

(b) Is not organized in the manner prescribed in
Form D-37 or contains one or more pages that are not numbered sequentially with
all the other pages in the claim; or

(c) Does not include information that, in the
discretion of the Administrator, is necessary for the Administrator to make a
recommendation to the Board pursuant to NAC 616B.7777.

6. If a claim is incomplete, the
Administrator may, not later than 15 days after the date that the claim is
served to the Administrator pursuant to subsection 2, serve notice, in writing,
to the association that the claim is incomplete. Such notice must include a
statement that sets forth the deficiencies in the claim. If the Administrator
serves notice that the claim is incomplete, the Administrator may retain the
claim or return the claim to the association.

7. If the Administrator serves notice to the
association that a claim is incomplete pursuant to subsection 6, the claim
shall not be deemed to be complete until the Administrator determines that the
association has corrected the deficiencies in the claim. If the association
fails to correct the deficiencies in the claim and the claim has not been
returned to the association, the Administrator may retain the claim or return
the claim to the association.

8. The provisions of this section do not
affect the authority of the Administrator to obtain additional information
related to the claim from the association or any other source after the claim
is deemed to be complete.

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R215-97, eff. 8-19-99)

NAC 616B.7775Inspection of records. (NRS 616B.572, 616B.578)Upon the
request of the Administrator, an association that serves a claim to the
Administrator pursuant to NAC 616B.7773 shall:

1. Allow the Administrator to inspect any
records related to the claim that are maintained by the association or a
third-party administrator of the association; or

2. Provide copies of those records to the
Administrator.

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R215-97, eff. 8-19-99)

1. Not later than 30 days after the date
that a claim is deemed to be complete pursuant to NAC
616B.7773, the Administrator shall serve, in writing, to the Board and the
association who submitted the claim the recommendation of the Administrator
concerning the approval or disapproval of the claim and any expenses of the
association related to the claim that the Administrator has verified pursuant to
the provisions of NAC 616B.707.

2. The Administrator shall include with the
recommendation:

(a) A statement of the issues of fact and law upon
which the Administrator bases the recommendation;

(b) A copy of each document that was served to or
obtained by the Administrator pursuant to NAC
616B.7773 and 616B.7775 and upon which the
Administrator bases the recommendation; and

(c) A list of each witness, if any, whom the
Administrator would likely call before the Board to support the recommendation,
if contested, and a brief summary of the proposed testimony of each such
witness.

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R215-97, eff. 8-19-99)

1. An association may contest all or part of
a recommendation of the Administrator made pursuant to NAC
616B.7777 by requesting a hearing before the Board.

2. An association that wishes to request a
hearing before the Board pursuant to subsection 1 must serve the request, in
writing, to the legal counsel of the Board not later than 10 days after the
date that the recommendation of the Administrator is served to the association.

1. Except as otherwise provided in
subsection 2, if an association does not timely request a hearing before the
Board to contest the recommendation of the Administrator pursuant to NAC 616B.7779:

(a) The Board, at a regularly scheduled meeting,
will approve or disapprove, in whole or in part, the recommendation of the
Administrator without allowing additional evidence, testimony, argument or
rebuttal to be presented by the association; and

(b) The Board will serve notice of its decision to
the association by personal service or certified mail, return receipt
requested, as soon as practicable.

2. If an association does not timely request
a hearing before the Board to contest the recommendation of the Administrator
pursuant to NAC 616B.7779 and the Board
disapproves, in whole or in part, the recommendation of the Administrator, the
association may request a hearing before the Board for reconsideration of only
that portion of the decision of the Board which disapproved the recommendation
of the Administrator.

3. An association that wishes to request a
hearing before the Board pursuant to subsection 2 must serve the request, in writing,
to the legal counsel of the Board not later than 10 days after the date that
the decision of the Board is served to the association.

(a) The Board will conduct a hearing not later than
35 days after the date that the request for a hearing is served by the
association, unless the Chair of the Board grants a continuance upon his or her
own motion or, for good cause shown, upon the request of the Administrator or
the association. To request a continuance, the Administrator or the association
must serve the request, in writing, to the legal counsel of the Board and the
other party not later than 5 days before the date of the hearing.

(b) The Chair of the Board shall serve notice of
the date, location and time of the hearing to the Administrator and the
association as soon as practicable, but not later than 10 days before the date
of the hearing.

(c) Not later than 5 days before the date of the
hearing, the association shall:

(1) Serve to the Administrator two copies of
the prehearing statement described in subsection 2; and

(2) Serve to the legal counsel of the Board
six copies of the prehearing statement described in subsection 2. The copies of
the prehearing statement served to the legal counsel of the Board must be
redacted to remove any information that may identify the injured employee who
is the subject of the claim. The redacted information must include, without
limitation, the name, address, date of birth and social security number of the
injured employee.

2. The association shall include in its
prehearing statement:

(a) A statement of the issues of fact and law upon
which the association bases its argument;

(b) A copy of each document which was served to or
obtained by the Administrator pursuant to NAC
616B.7773 and 616B.7775 and which the
association intends to introduce at the hearing;

(c) A list of each witness, if any, whom the
association intends to call at the hearing and a brief summary of the proposed
testimony of each such witness;

(d) An estimate of the time that the association
will need to present its evidence, testimony, argument and rebuttal at the
hearing; and

(e) If the association requires a court reporter to
be present at the hearing, a request that the Board provide a court reporter
for the hearing and a statement attesting that the association will pay all
costs related to the services of the court reporter and all costs that are
necessary to provide the Board with a copy of the transcript of the hearing.

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R215-97, eff. 8-19-99)

1. The Board will conduct a hearing that is
requested pursuant to NAC 616B.7779 or 616B.7781 fairly and impartially to ensure that the
facts are elicited fully, all issues are adjudicated and any unnecessary delay
is avoided.

2. To the extent consistent with the
provisions of NAC 616B.777 to 616B.779, inclusive, the Board will conduct the
hearing pursuant to the provisions of chapter
233B of NRS that relate to contested cases and, if practicable, the Board
will apply the rules of procedure and evidence that apply to the district
courts of this State.

3. Any objection to the conduct of the
hearing, including, without limitation, an objection to the introduction of
evidence, must be addressed to the Chair of the Board who, in consultation with
the other members of the Board and the legal counsel of the Board, will rule
upon the objection. If any evidence is excluded from the record, the party who
is offering the evidence may make an offer of proof to the Chair of the Board.
Such an offer of proof must be included in the record.

4. The Board will direct that an audio
recording of the hearing be made, unless the association requested in its prehearing
statement that the Board provide a court reporter for the hearing. If the Board
provides a court reporter for the hearing upon the request of the association,
the association shall pay all costs related to the services of the court
reporter and all costs that are necessary to provide the Board with a copy of
the transcript of the hearing.

5. After the hearing, the Board will:

(a) If the association is contesting the
recommendation of the Administrator pursuant to NAC
616B.7779, approve or disapprove, in whole or in part, the recommendation
of the Administrator; or

(b) If the association is seeking reconsideration
of a previous decision pursuant to NAC 616B.7781,
affirm or amend, in whole or in part, the previous decision.

6. The Board will direct the legal counsel
of the Board to prepare a written decision for the Board that includes findings
of fact and conclusions of law for the decision. The Chair of the Board will
sign the decision of the Board. The Board will serve its decision to the
association by personal service or certified mail, return receipt requested.

7. Not later than 10 days after the date that
the decision of the Board is served to the association, the association may
serve to the legal counsel of the Board written objections to the decision of
the Board. Any such written objections that are timely served to the legal
counsel of the Board must be included in the record.

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R215-97, eff. 8-19-99)

NAC 616B.7787Request for transcript of hearing. (NRS 616B.572, 616B.578)An
association that requests a hearing before the Board pursuant to NAC 616B.7779 or 616B.7781
may request a transcript of any audio recording that is made of the hearing. If
the association requests such a transcript, the association shall pay all costs
related to the preparation of the transcript and all costs that are necessary
to provide the Board with a copy of the transcript.

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R215-97, eff. 8-19-99)

NAC 616B.7788Representation by legal counsel. (NRS 616B.572, 616B.578)At any
meeting or hearing conducted by the Board:

1. The Administrator and the Board may be
represented by legal counsel; and

2. An association that is authorized to
appear before the Board may be represented by a representative of its choice,
but the association remains the real party in interest during all proceedings.

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R215-97, eff. 8-19-99)

NAC 616B.7789Withdrawal from proceeding by member of Board. (NRS 616B.572, 616B.578)A member
of the Board may withdraw from participating in a proceeding before the Board
whenever the member considers himself or herself to be disqualified.

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R215-97, eff. 8-19-99)

NAC 616B.779Claims barred when association fails to pay assessment or
penalty. (NRS
616B.572, 616B.575, 616B.578)If an
association fails to pay any portion of an assessment or penalty which is
related to administration of the Account and which has been assessed against
the association pursuant to the provisions of this chapter, the association may
not submit a claim to the Board, have a claim considered by the Board or
receive payment for any claim that has been approved by the Board until the
association pays the unpaid assessment or penalty in full.

(Added to NAC by Bd. for Admin. of Subsequent Injury
Fund for Ass’ns of Self-Insured Pub. or Private Employers by R215-97, eff. 8-19-99)

1. An employer who hires a person to do work
related to, or in furtherance of, his or her business operations that are
insured by a private carrier is presumed to have established an
employer-employee relationship between himself or herself and the person
performing the work in the absence of a written contract between the two
parties which establishes that no employer-employee relationship exists between
the two parties, in accordance with chapters
616A to 617, inclusive, of NRS.

2. If a subcontractor or independent
contractor does not have an active policy with a private carrier, the principal
contractor must be assessed premiums based on:

(a) The payroll for the period of the contract with
the subcontractor or independent contractor;

(b) The appropriate classification for the work performed
by the subcontractor or independent contractor; and

(c) The experience modification factor of the
principal contractor.

3. A principal contractor may provide the
complete payroll records of the employees of each uninsured subcontractor and
independent contractor. Except as otherwise provided in this subsection, if the
principal contractor does not provide the complete payroll records of the
uninsured subcontractors and independent contractors, the full contract price
shall be deemed to be the payroll for the employees of the subcontractors and
independent contractors. If the contract is for labor and materials or labor
and equipment and evidence is provided to the private carrier which indicates
the portion of the contract price that is for labor, that amount may be deemed
the payroll for the employees of the subcontractor or independent contractor.
If such an amount is not indicated in the contract, the private carrier shall
determine what portion of the contract price will be deemed the payroll for the
employees of the subcontractor or independent contractor. In no case may the
payroll used to calculate the premiums of the principal contractor be less than
the portion of the contract price that is for labor.

4. If a subcontractor or independent contractor
has a policy with a private carrier but fails to pay the proper premiums, the
principal contractor is liable for the amount of any unpaid premiums based on
the rate and modification factor for premiums of the subcontractor or
independent contractor.

(Added to NAC by Div. of Industrial Relations by R112-98,
12-18-98, eff. 7-1-99)

1. A sole proprietor acting as a
subcontractor in this State who is licensed pursuant to chapter 624 of NRS shall be deemed to
receive $500 per month in wages. A sole proprietor acting in alternating roles
as a principal contractor and subcontractor shall be deemed to receive $500 per
month in wages. The type of license issued to the sole proprietor pursuant to chapter 624 of NRS does not affect the
coverage or deemed wage required.

2. A sole proprietor acting only as a
principal contractor may be relieved of the requirement of maintaining coverage
for himself or herself by submitting written notice to the private carrier
which insures him or her that he or she is acting only as a principal
contractor. If the private carrier determines that the sole proprietor is
acting only as a principal contractor, the private carrier shall terminate his
or her deemed wage effective on the date of receipt of the written notice. The
termination of the deemed wage must not be made retroactive to a date before
receipt of the written notice by the private carrier. If, after the termination
of the deemed wage, the private carrier determines that the sole proprietor was
at any time acting as a subcontractor, the private carrier shall reinstate the
deemed wage effective on the date on which it was terminated, but in no case
may it be made retroactive for more than 3 years or to the date of the last
audit, whichever is more recent. If a sole proprietor who was determined to be
acting only as a principal contractor at the inception of his or her policy
with a private carrier acts at any time thereafter as a subcontractor or in
alternating roles as a principal contractor and subcontractor, his or her
deemed wage becomes effective on the date of his or her first subcontract, but
in no case may it be made retroactive for more than 3 years or to the date of
the last audit, whichever is more recent.

3. If a sole proprietor acting as a
subcontractor provides coverage for his or her employees but fails to secure
and maintain coverage for himself or herself, the principal contractor is
responsible for the payment of premiums for the sole proprietor during the term
of the contract.

(Added to NAC by Div. of Industrial Relations by R112-98,
12-18-98, eff. 7-1-99)

1. For the purposes of determining premium
and disability compensation, the wage of a sole proprietor who is not licensed
pursuant to chapter 624 of NRS, has
not elected coverage under the elective provisions of chapters 616A to 617, inclusive, of NRS and is performing
as a subcontractor to an insured principal contractor shall be deemed to be
$300 per month or $10 per day for the period of the subcontract, unless the
contract specifies a wage greater than $300 per month or $10 per day for the
sole proprietor.

2. For the purposes of determining premium
and disability compensation, the wage of a sole proprietor who is licensed
pursuant to chapter 624 of NRS but who
has failed to open or maintain an account in good standing and who is
performing as a subcontractor to an insured principal contractor shall be
deemed to be $500 per month or $17 per day for the period of the subcontract
unless the contract specifies a wage greater than $500 per month or $17 per day
for the sole proprietor.

3. For the purposes of determining the
premium required to be paid by the principal contractor and disability
compensation, the wages of an employee of a sole proprietor who is a
subcontractor and has not obtained coverage for his or her employees must be
the actual wages paid, if the payroll records are provided to the private
carrier. In the absence of complete payroll records, subsection 3 of NAC 616B.780 applies.

4. The principal contractor is liable for
the amount of any premiums payable as a result of the application of
subsections 1, 2 and 3. The premium payable must be based on the
classifications and rates that would be applicable to the subcontractor and the
experience modification factor which would be applicable to the principal
contractor.

(Added to NAC by Div. of Industrial Relations by R112-98,
12-18-98, eff. 7-1-99)

1. A sole proprietor who is not licensed
pursuant to chapter 624 of NRS, but
who is required by statute to provide industrial insurance for himself or
herself to obtain, fulfill or both obtain and fulfill a contract to furnish
service to the State, will be provided coverage during the term of the contract
at the rate provided in the manual at the deemed wage of $300 per month.

2. If a sole proprietor who is licensed
pursuant to chapter 624 of NRS accepts
a state contract, coverage will be provided at the deemed wage of $500 per
month whether or not the license is material to the state contract. Coverage
will be provided during the term of the contract or as long as the sole
proprietor is licensed at the rate provided in the manual for licensed sole
proprietors.

(Added to NAC by Div. of Industrial Relations by R112-98,
12-18-98, eff. 7-1-99)

NAC 616B.795Coverage of corporate officers. (NRS 616A.400)A
private carrier shall provide coverage to an officer of a corporation if the
corporation is required to be insured pursuant to NRS 616B.624 or has elected to be
insured pursuant to chapters 616A to
617, inclusive, of NRS, including,
without limitation:

1. An officer of a corporation under
subchapter S of the Internal Revenue Code, who is regularly employed by the
corporation in the State of Nevada, or who is from a nonreciprocating state
working temporarily in the State of Nevada, based upon the amounts deemed to be
paid to him or her pursuant to chapters
616A to 617, inclusive, of NRS, or
based on the actual amount paid to him or her as shown on the records of
payroll maintained by the corporation, but excluding any dividends paid to him
or her; and

2. An officer of a corporation who may be
excluded pursuant to NRS 616A.110,
but is required to be insured pursuant to NRS 616B.624, or elects to be insured
pursuant to chapters 616A to 617, inclusive, of NRS.

(Added to NAC by Div. of Industrial Relations by R112-98,
12-18-98, eff. 7-1-99)

NAC 616B.796Certain provisions not applicable to coverage of corporate
officer. (NRS
616A.110, 616A.400, 616B.624)The
Administrator will not interpret the provisions of NRS 616A.110 as affecting the
requirements for the coverage of a corporate officer set forth in NRS 616B.624.

(Added to NAC by Div. of Industrial Relations by R112-98,
12-18-98, eff. 7-1-99)

1. If an employer elects to cover an
employee who is excluded from the benefits of chapters 616A to 617, inclusive, of NRS pursuant to NRS 616A.110 or if the employer
subsequently wishes to withdraw such an election, the written statement or
notice that the employer is required to provide pursuant to subsection 2 of NRS 616B.656 to his or her
insurer and the Administrator must be served personally or sent by first-class
mail on a completed form entitled “D-44, Election of Coverage by Employer and
Employer Withdrawal of Election of Coverage,” which is prescribed by the
Administrator, or, if sent by electronic transmission, the notice must contain
the same information as the form. The notice must be provided within 30 days
after the effective date of the election or withdrawal. The employer is not
required to serve the notice on the Administrator if notice is served on the
Administrator by the insurer on behalf of the employer.

2. If an employee that is excluded from the
benefits of chapters 616A to 617, inclusive, of NRS pursuant to NRS 616A.110 rejects coverage
elected by his or her employer pursuant to NRS 616B.656 or if the employee
subsequently elects to waive such a rejection, the written notice that the
employee must provide to the employer, the insurer of the employer and the
Administrator pursuant to subsection 3 of NRS 616B.656 must be served
personally or sent by first-class mail on a completed form entitled “D-43,
Employee’s Election to Reject Coverage and Election to Waive the Rejection of
Coverage for Excluded Persons,” which is prescribed by the Administrator, or,
if sent by electronic transmission, the notice must contain the same
information as the form. The notice must be provided within 30 days after the
effective date of the election or rejection. The employee is not required to
serve the notice on the Administrator if notice is served on the Administrator
by the insurer on behalf of the employee.

1. If a sole proprietor elects to purchase
industrial insurance pursuant to chapters
616A to 617, inclusive, of NRS or
elects to pay an additional amount of premium for additional coverage or
subsequently wishes to withdraw an election for coverage, the written notice
that the sole proprietor is required to provide to the private carrier and the
Administrator pursuant to NRS
616B.659 must be served personally or sent by first-class mail on a
completed form entitled “D-45, Sole Proprietor Coverage,” which is prescribed
by the Administrator, or, if sent by electronic transmission, the notice must
contain the same information as the form. The notice must be served within 30
days after the effective date of the election or withdrawal and must be
accompanied by a report of any physical examinations prescribed by the private
carrier. The sole proprietor is not required to serve the notice on the
Administrator if notice is served on the Administrator by the private carrier
on behalf of the sole proprietor.

2. A sole proprietor for whom coverage is
elective pursuant to NRS 616A.220,
who meets the qualifications for elective coverage pursuant to that section and
who is not otherwise required to maintain coverage pursuant to chapters 616A to 616D, inclusive, or chapter 617 of NRS, must comply with the
requirements set forth in NAC 616B.810.

3. Except as otherwise provided in
subsection 4, for the purposes of determining premium and disability
compensation, a sole proprietor who applies for coverage pursuant to NRS 616B.659 will be provided
coverage at the rate provided in the manual at the deemed wage of $300 per
month or, if additional premiums are received for additional coverage, at the
deemed wage of $1,800 per month. A sole proprietor who:

(a) Files notice with a private carrier, pursuant
to NRS 616B.659, of his or her
election to pay for additional coverage; and

(b) Sustains an injury within the 90-day period
provided by subsection 6 of NRS
616B.659,

Ê will be
provided coverage at the deemed wage of $300 per month, notwithstanding the
election to pay for additional coverage.

4. The private carrier may increase the
monthly premium payable pursuant to subsection 3 based on the results of the
physical examination prescribed by the private carrier.

(Added to NAC by Div. of Industrial Relations by R112-98,
12-18-98, eff. 7-1-99; A by R105-00, 1-18-2001, eff. 3-1-2001)

1. A person who is licensed pursuant to chapter 645 of NRS as a real estate
broker, broker-salesperson or salesperson and who is not otherwise required to
maintain coverage pursuant to chapters
616A to 617, inclusive, of NRS may
elect coverage pursuant to NRS
616A.220 by submitting to a private carrier:

(a) An original application for industrial
insurance; or

(b) A separate election form or a letter signed by
the licensee.

2. A licensee who elects coverage pursuant
to NRS 616A.220 will be
assigned a classification based on his or her occupation as a licensed real
estate broker, broker-salesperson or salesperson at the deemed wage of $1,500
per month.

(Added to NAC by Div. of Industrial Relations by R112-98,
12-18-98, eff. 7-1-99)

1. Elective coverage of volunteers becomes
effective on the date on which the employer’s application for such coverage is
approved and accepted:

(a) In the case of an employer who is not
self-insured or a member of an association, by a private carrier.

(b) In the case of a self-insured employer or a
member of an association, by the Administrator.

2. The private carrier shall, in the case of
a sponsoring employer insured by it, assign a separate classification from the
manual for the employer to use in reporting the payroll and premium of the
volunteers.

3. The deemed wage of $100 is reportable for
each volunteer who is on the active roster of the sponsored organization for
any part of a month.

(a) The electing employer, if he or she is insured
by a private carrier, notifies the private carrier, or if he or she is a
self-insured employer or member of an association, notifies the Administrator,
that the coverage is to be terminated; or

(b) The Administrator or the private carrier finds
that an employer electing coverage has not maintained a current roster of
volunteers,

Ê whichever
occurs earlier.

2. If the private carrier terminates
coverage pursuant to paragraph (b) of subsection 1, the private carrier must do
so by the issuance of an endorsement changing the coverage of the electing
employer’s policy.

3. For an employer who is insured by a
private carrier, the premium for any period during which coverage was active
but the employer did not maintain a roster must be based on the greater of
either the number of volunteers who were declared on the application for
coverage, or the largest number of volunteers provided on prior rosters.

(Added to NAC by Div. of Industrial Relations by R112-98,
12-18-98, eff. 7-1-99)

Consolidated Insurance Programs

NAC 616B.911Contents of contract to provide insurance for program. (NRS 616B.720, 616B.737)Each
contract for the provision of industrial insurance coverage for a consolidated
insurance program that must be filed with the Commissioner pursuant to NRS 616B.712 must, in addition to
the elements required by NRS
616B.720, include or be accompanied by:

1. A statement of the estimated total cost
of the construction project that itemizes how much of that cost is attributable
to:

(a) Constructing the project;

(b) Designing the project;

(c) Acquiring the real property on which the
project will be constructed;

(d) Connecting the project to utilities;

(e) Excavating and carrying out underground
improvements for the project; and

(f) Acquiring equipment and furnishings for the
project.

2. Evidence satisfactory to prove that the
two persons hired or contracted pursuant to NRS 616B.725 to serve as the
primary and alternate coordinators for safety:

(a) Possess credentials in the field of safety; and

(b) Have at least 3 years of the type of experience
in overseeing matters of occupational safety and health in the field of
construction,

Ê that the
Administrator has determined are adequate to prepare a person to act as a
coordinator for safety for a construction project.

3. A statement issued and signed by the:

(a) Owner of the construction project, if the
contract covers an owner-controlled insurance program; or

(b) Principal contractor of the construction
project, if the contract covers a contractor-controlled insurance program,

Ê which
declares that the primary and alternate coordinators for safety for the
construction project will not serve as coordinators for safety for another
construction project that is covered by a different consolidated insurance
program.

4. A statement issued and signed by the:

(a) Owner of the construction project, if the
contract covers an owner-controlled insurance program; or

(b) Principal contractor of the construction
project, if the contract covers a contractor-controlled insurance program,

Ê which
declares that the person hired or contracted pursuant to NRS 616B.727 to serve as the
administrator of claims for industrial insurance for the construction project
will not serve as an administrator of claims for industrial insurance for
another construction project that is covered by a different consolidated
insurance program.

5. A copy of a plan or other materials
developed by the:

(a) Owner of the construction project, if the
contract covers an owner-controlled insurance program; or

(b) Principal contractor of the construction
project, if the contract covers a contractor-controlled insurance program,

Ê that he or
she will use to provide the information required to be provided by subsection 2
of NRS 616B.735 to potential
contractors and subcontractors at the pre-bid conference. The plan or materials
must contain all the information specified in paragraphs (a) to (d), inclusive,
of subsection 2 of NRS 616B.735.

6. A list of all other lines of insurance
that will be included in the consolidated insurance program for the
construction project.

(Added to NAC by Comm’r of Insurance by R138-99, eff. 1-27-2000)

NAC 616B.915Submission of new information to Commissioner upon change of information
in contract. (NRS
616B.737)If
a change occurs to any of the information specified in NAC
616B.911, the private company, public entity or utility that filed the
contract with the Commissioner shall submit the new information to the
Commissioner within 14 calendar days after the change occurs.

(Added to NAC by Comm’r of Insurance by R138-99, eff. 1-27-2000)

NAC 616B.917Determination of loss experience.
(NRS 616B.732, 616B.737)If an
owner or principal contractor establishes and administers a consolidated
insurance program pursuant to NRS
616B.710, each employee of a contractor or subcontractor who is covered
under the consolidated insurance program:

1. If the consolidated insurance program is
established before July 1, 2007, shall be deemed to be an employee of the owner
or principal contractor for the purpose of determining the loss experience of
the owner or principal contractor.

2. If the consolidated insurance program is
established on or after July 1, 2007:

(a) Is an employee of the contractor or
subcontractor for the purpose of determining the loss experience of the
contractor or subcontractor.

(b) Shall not be deemed to be an employee of the
owner or principal contractor for the purpose of determining the loss
experience of the owner or principal contractor.

(Added to NAC by Comm’r of Insurance by R204-08, eff.
12-17-2008)

MODIFIED PROGRAM FOR OFFENDERS IN LOCAL WORK PROGRAMS

NAC 616B.922Scope. (NRS 616B.029)The
provisions of NAC 616B.922 to 616B.948, inclusive, apply only to an offender who is
injured or killed in the course and scope of his or her employment in a work
program directed by the administrator of a county jail, city jail or other
local detention facility and only if the administrator of the jail or other
detention facility has provided and secured coverage from an insurer under the
modified program of industrial insurance pursuant to NRS 616B.029. The program does
not include:

1. Coverage for an injury that occurred
before the offender was confined at a county jail, city jail or other local
detention facility.

2. Any service or benefit for vocational
rehabilitation.

(Added to NAC by Div. of Industrial Relations by R209-97,
eff. 4-17-98)

NAC 616B.924Applicability of statutes and other regulations. (NRS 616B.029)Except
as otherwise provided in NAC 616B.922, the
provisions of chapters 616A to 617, inclusive, of NRS and chapters 616A to 617,
inclusive, of NAC apply to any offender confined at a county jail, city jail or
other local detention facility and engaged in employment in a work program to
the extent that those provisions do not conflict with NAC
616B.922 to 616B.948, inclusive.

(Added to NAC by Div. of Industrial Relations by R209-97,
eff. 4-17-98)

NAC 616B.926“Wages” defined. (NRS 616B.029)In the
case of an offender confined at a county jail, city jail or other local
detention facility who is injured or killed in the course and scope of his or
her employment in the work program, the term “wages”:

1. Includes only the money he or she earns
in the work program before any deductions are made from those earnings.

2. Does not include:

(a) The value of room and board, medical care or
other goods or services provided by the county jail, city jail or other local
detention facility;

(b) The value of good time earned towards reducing
the sentence of the offender; or

(c) Income from any source other than the work
program.

(Added to NAC by Div. of Industrial Relations by R209-97,
eff. 4-17-98)

NAC 616B.928Statement of rights and duties of offenders. (NRS 616B.029)The
administrator of the county jail, city jail or other local detention facility
or a designated agent thereof shall:

1. Adopt a written statement of the rights
and duties of an offender pursuant to the provisions of NAC
616B.922 to 616B.948, inclusive. The statement
must include the procedures and time limits that the offender must follow when
filing for benefits.

2. Give a copy of the statement to each
offender confined at a county jail, city jail or other local detention facility
before the offender’s first assignment to work.

3. Post a copy of the statement in a
conspicuous place of an area, to which the offender has access, in the county
jail, city jail or other local detention facility where the offender is
incarcerated.

(Added to NAC by Div. of Industrial Relations by R209-97,
eff. 4-17-98)

NAC 616B.930Injuries for which compensation not allowed. (NRS 616B.029)No
compensation may be authorized pursuant to NAC
616B.922 to 616B.948, inclusive, for an injury
that:

1. Results from an assault, whether or not
the offender is the aggressor.

2. Occurs as a result of a deliberate
violation of a rule of the work program by the offender.

3. Is proximately caused by the offender’s
intoxication. If the employee was intoxicated at the time of the injury,
intoxication must be presumed to be a proximate cause unless rebutted by
evidence to the contrary.

4. Is proximately caused by the employee’s
use of a controlled substance. If the employee had any amount of a controlled
substance in his or her system at the time of the injury for which the employee
did not have a current and lawful prescription issued in his or her name, the
controlled substance must be presumed to be a proximate cause unless rebutted
by evidence to the contrary.

(Added to NAC by Div. of Industrial Relations by R209-97,
eff. 4-17-98)

1. Except as otherwise provided in
subsections 2 and 3, an offender or someone acting on his or her behalf shall
submit the notice of injury pursuant to the provisions of NRS 616C.015.

2. The notice of injury must be submitted to
the administrator of the county jail, city jail or other local detention
facility or a designated agent thereof.

3. The administrator of the jail or other
detention facility or a designated agent shall file the notice with its insurer
within 15 days after he or she receives it. If an offender submits the notice
of injury to the administrator of the jail or other detention facility or a
designated agent within the time provided by NRS 616C.015, the failure of the
administrator of the jail or other detention facility or a designated agent to
file the notice with its insurer within 15 days does not bar a claim for
compensation.

4. Incarceration is not an excuse for
failure to submit a timely notice of injury.

(Added to NAC by Div. of Industrial Relations by R209-97,
eff. 4-17-98)

NAC 616B.934Periods for accrual and payment of compensation. (NRS 616B.029)

1. An offender is not entitled to accrue or
be paid any compensation for temporary total disability, temporary partial
disability, permanent partial disability or permanent total disability while
incarcerated.

2. Payment of compensation begins upon the
release of the offender from incarceration on:

(a) Parole;

(b) Final discharge; or

(c) Discharge from custody by order of a court of
competent jurisdiction.

3. Compensation must be discontinued during
any subsequent period of incarceration in:

(a) A facility of the Department of Corrections;

(b) Any other federal or state prison system; or

(c) A county jail, city jail or other local
detention facility.

(Added to NAC by Div. of Industrial Relations by R209-97,
eff. 4-17-98)

NAC 616B.936Payment of lump-sum benefits. (NRS 616B.029)An
offender must not be paid a lump-sum settlement for an injury or disease while
incarcerated. When the offender is released, any lump-sum benefit to which he
or she is entitled:

1. Of more than $2,400, must be paid in
monthly installments that do not exceed 10 percent of the total benefit in any
month. The first installment must be paid within 30 days after the insurer
receives written notice, from the offender or the administrator of the county
jail, city jail or other local detention facility where the offender was
incarcerated, that the offender has been released.

2. Of $2,400 or less, must be paid in a single
payment within 30 days after the insurer receives written notice, from the
offender or the administrator of the county jail, city jail or other local
detention facility where the offender was incarcerated, that the offender has
been released.

(Added to NAC by Div. of Industrial Relations by R209-97,
eff. 4-17-98)

1. Except as otherwise provided in this
section, the administrator of the county jail, city jail or other local
detention facility or a designated agent thereof has control over the medical
treatment of any offender, including the right to select a treating, consulting
and rating physician or chiropractor, or both, and any other health care
professionals. An offender is not entitled to select a health care
professional.

2. The county jail, city jail or other local
detention facility is not required to disclose in advance to the offender the
date, time or location of any medical service.

3. The insurer may schedule any appropriate
medical test, consultation or treatment in addition to those scheduled by the
county jail, city jail or other local detention facility, but shall do so in
accordance with the security procedures of the jail or other detention
facility.

4. If an insurer schedules an evaluation to
determine if an offender has suffered a permanent partial disability, it must
use a rating physician or chiropractor who has been designated by the
Administrator to determine the disability pursuant to NRS 616C.490 but is not required
to select the next physician or chiropractor according to the order in which
their names appear on the list maintained by the Administrator.

5. If medication is prescribed for an
offender, it must be retained and dispensed by the county jail, city jail or
other local detention facility.

(Added to NAC by Div. of Industrial Relations by R209-97,
eff. 4-17-98)

1. An offender is not entitled to be
physically present at a hearing before a hearing officer or an appeals officer.

2. Any hearing must be conducted by
telephone unless the appeals officer or hearing officer determines, for good
cause, that the hearing should be held at a county jail, city jail or other
local detention facility. In such a case, the hearing must be arranged and
conducted in accordance with the security procedures of the county jail, city
jail or other local detention facility.

(Added to NAC by Div. of Industrial Relations by R209-97,
eff. 4-17-98)

NAC 616B.942Services of Nevada Attorney for Injured Workers. (NRS 616B.029)Offenders
are entitled to the services of the Nevada Attorney for Injured Workers,
subject to the rules and procedures adopted by the county jail, city jail or
other local detention facility relating to contact with offenders.

(Added to NAC by Div. of Industrial Relations by R209-97,
eff. 4-17-98)

NAC 616B.944Low wage is not ground to reopen claim. (NRS 616B.029)The fact
that an offender has earned a relatively low wage while incarcerated is not a
ground for the reopening of a claim.

(Added to NAC by Div. of Industrial Relations by R209-97,
eff. 4-17-98)

NAC 616B.946No right to reject coverage. (NRS 616B.029)An
offender incarcerated in a county jail, city jail or other local detention
facility may not reject coverage if the administrator of the county jail, city
jail or other local detention facility has provided and secured coverage from
an insurer under the modified program of industrial insurance pursuant to NRS 616B.029.

(Added to NAC by Div. of Industrial Relations by R209-97,
eff. 4-17-98)

NAC 616B.948Civil
rights not restored. (NRS 616B.029)NAC 616B.922 to 616B.948,
inclusive, do not restore, in whole or in part, any of the civil rights of an
offender.

(Added to NAC by Div. of Industrial Relations by R209-97,
eff. 4-17-98)

MODIFIED PROGRAM FOR OFFENDERS IN PRISON INDUSTRY PROGRAMS

NAC 616B.960Scope. (NRS 616B.028)The
provisions of NAC 616B.960 to 616B.986, inclusive, apply only to an offender who is
injured or killed in the course and scope of his or her employment in the
prison industry program, and only if the Director of the Department of
Corrections obtained coverage from an insurer under the modified program of
industrial insurance. The program does not include:

1. Coverage for an injury that occurred
before the offender was confined in an institution or facility operated by the
Department of Corrections.

2. Any service or benefit for vocational
rehabilitation.

(Added to NAC by Div. of Industrial Relations by R072-99,
eff. 10-28-99)

NAC 616B.962Applicability of statutes and other regulations. (NRS 616B.028)Except
as otherwise provided in NAC 616B.960, the
provisions of chapters 616A to 617, inclusive, of NRS and chapters 616A to 617,
inclusive, of NAC apply to an offender confined in an institution or facility
operated by the Department of Corrections and engaged in work in a prison
industry program to the extent that those provisions do not conflict with the
provisions of NAC 616B.960 to 616B.986, inclusive.

(Added to NAC by Div. of Industrial Relations by R072-99,
eff. 10-28-99)

NAC 616B.964“Wages” defined. (NRS 616B.028)For the
purposes of an offender confined in an institution or facility operated by the
Department of Corrections who is injured or killed in the course and scope of
his or her employment in the prison industry program, “wages”:

1. Means the money he or she earns in the
prison industry program before any deductions are made from those earnings.

2. Does not include:

(a) The value of room and board, medical care and
other goods and services provided by the Department of Corrections.

(b) The value of good time earned towards reducing
the prison sentence of the offender.

(c) Income from any source other than the prison
industry program.

(Added to NAC by Div. of Industrial Relations by R072-99,
eff. 10-28-99)

1. Adopt a written procedure that
establishes the rights and duties of an offender pursuant to the provisions of NAC 616B.960 to 616B.986,
inclusive. The procedure must include the manner for filing a claim for
compensation, including the period within which a claim must be filed.

2. Provide a copy of the procedure to each
offender confined in an institution or facility operated by the Department of
Corrections before his or her first assignment to work.

3. Display a copy of the procedure in a
conspicuous place to which the offender has access in an institution or
facility where the offender is incarcerated.

(Added to NAC by Div. of Industrial Relations by R072-99,
eff. 10-28-99)

NAC 616B.968Injuries for which compensation not allowed. (NRS 616B.028)An
offender is not entitled to receive compensation pursuant to the provisions of NAC 616B.960 to 616B.986,
inclusive, for an injury that:

1. Results
from an assault, regardless of whether the offender is the aggressor.

2. Occurs as a result of an intentional
violation of a work rule of the work program by the offender.

3. Is proximately caused by the offender’s
intoxication. If the employee was intoxicated at the time of the injury,
intoxication must be presumed to be a proximate cause of the injury unless
rebutted by evidence to the contrary.

4. Is proximately caused by the offender’s
use of a controlled substance. If the employee has any amount of a controlled
substance in his or her system at the time of the injury for which the employee
did not have a current and lawful prescription issued in his or her name, the
controlled substance must be presumed to be a proximate cause of the injury
unless rebutted by evidence to the contrary.

(Added to NAC by Div. of Industrial Relations by R072-99,
eff. 10-28-99)

1. Except as otherwise provided in
subsections 2 and 3, an offender or any person acting on his or her behalf
shall submit the notice of injury in the manner provided in NRS 616C.015.

2. The notice of injury must be submitted to
the Deputy Director of Industrial Programs of the Department of Corrections.

3. The Deputy Director of Industrial
Programs shall file the notice with the insurer providing coverage under the
modified program of industrial insurance within 15 days after receiving the
notice. If the offender or a person acting on his or her behalf submits the
notice of injury to the Deputy Director within the time prescribed by NRS 616C.015, the failure of the
Deputy Director to file the notice with the insurer within 15 days does not bar
a claim for compensation.

4. Incarceration of the offender is not an
excuse for failure to submit a notice of injury within the period prescribed by
NRS 616C.015.

(Added to NAC by Div. of Industrial Relations by R072-99,
eff. 10-28-99)

NAC 616B.972Periods for accrual and payment of compensation. (NRS 616B.028)

1. An offender is not entitled to accrue or
receive any compensation for temporary total disability, temporary partial
disability, permanent partial disability or permanent total disability while
incarcerated.

2. The insurer shall schedule an evaluation
of the offender before his or her release to determine whether the industrial
injury of the offender will affect his or her ability to work.

3. The payment of compensation begins upon
the release of the offender from incarceration on:

(a) Parole;

(b) Final discharge; or

(c) Discharge from custody by order of a court of
competent jurisdiction.

4. The payment of compensation must be
discontinued during any subsequent period of incarceration in:

(a) An institution or facility operated by the
Department of Corrections;

(b) Any federal or state prison system; or

(c) A county jail, city jail or other local
detention facility.

(Added to NAC by Div. of Industrial Relations by R072-99,
eff. 10-28-99)

1. An offender is not entitled to receive a
lump-sum settlement for an injury or disease while incarcerated.

2. The insurer shall schedule an evaluation
of the offender before his or her release to determine whether the industrial
injury of the offender will affect his or her ability to work.

3. When the offender is released, any
lump-sum benefit to which he or she is entitled that:

(a) Is more than $2,400, must be paid in monthly
installments that do not exceed 10 percent of the total benefit in any month.
The first installment must be paid within 30 days after the insurer receives
written notice from the offender, the warden of the institution or the manager
of the facility where the offender was incarcerated or a person designated by
the warden or manager that the offender has been released.

(b) Is $2,400 or less, must be paid in a single
payment within 30 days after the insurer receives written notice from the
offender, the warden of the institution or manager of the facility where the
offender was incarcerated or a person designated by the warden or manager that
the offender has been released.

(Added to NAC by Div. of Industrial Relations by R072-99,
eff. 10-28-99)

1. Except as otherwise provided in this
section, the Department of Corrections has control over the medical treatment
of an offender, including the right to select a treating, consulting and rating
physician or chiropractor, or both, and any other practitioner. An offender is
not entitled to select a practitioner. As used in this subsection,
“practitioner” has the meaning ascribed to it in NRS 439A.0195.

2. The Department of Corrections is not
required to disclose in advance to the offender the date, time or location of
any medical service.

3. The insurer may schedule any appropriate
medical test, consultation or treatment in addition to those scheduled by the
Department of Corrections, but shall do so in accordance with the security
procedures of the Department of Corrections.

4. If the insurer schedules an evaluation to
determine whether an offender has suffered a permanent partial disability, it
must use a rating physician or chiropractor designated by the Administrator to
determine the disability pursuant to NRS 616C.490, but it is not
required to select the next physician or chiropractor according to the order in
which their names appear on the list maintained by the Administrator.

5. If medication is prescribed for an
offender, it must be retained and dispensed by the Department of Corrections.

(Added to NAC by Div. of Industrial Relations by R072-99,
eff. 10-28-99)

1. An offender is not entitled to be present
at a hearing before a hearing officer or an appeals officer.

2. A hearing must be conducted by telephone
unless the appeals officer or hearing officer determines, for good cause, that
the hearing should be held at an institution operated by the Department of Corrections.
In such a case, the hearing must be arranged and conducted in accordance with
the security procedures of the Department of Corrections.

(Added to NAC by Div. of Industrial Relations by R072-99,
eff. 10-28-99)

NAC 616B.980Services of Nevada Attorney for Injured Workers. (NRS 616B.028)An
offender is entitled to the services of the Nevada Attorney for Injured
Workers, subject to the rules and procedures adopted by the Department of
Corrections relating to contact with offenders.

(Added to NAC by Div. of Industrial Relations by R072-99,
eff. 10-28-99)

NAC 616B.982Low wage is not ground to reopen claim. (NRS 616B.028)The fact
that an offender has earned a relatively low wage during incarceration is not a
ground for the reopening of a claim.

(Added to NAC by Div. of Industrial Relations by R072-99,
eff. 10-28-99)

NAC 616B.984No right to reject coverage. (NRS 616B.028)An
offender who is confined in an institution or facility operated by the
Department of Corrections may not reject coverage if the Director of the
Department of Corrections has obtained coverage under the modified program of
industrial insurance.

(Added to NAC by Div. of Industrial Relations by R072-99,
eff. 10-28-99)

NAC 616B.986Civil rights not restored. (NRS 616B.028)The
provisions of NAC 616B.960 to 616B.986, inclusive, do not restore, in whole or in
part, any of the civil rights of an offender.

(Added to NAC by Div. of Industrial Relations by R072-99,
eff. 10-28-99)

1. Except as otherwise provided in this
section, the provisions of NAC 616B.990 to 616B.994, inclusive:

(a) Govern all practices and procedures for a
hearing held pursuant to NRS
616B.760 to 616B.790,
inclusive; and

(b) Must be liberally construed to secure the just
and speedy determination of all issues presented to the Appeals Panel.

2. Except as otherwise provided by specific
statute, for good cause shown, the Appeals Panel may authorize deviation from
the provisions of NAC 616B.990 to 616B.994, inclusive, if all parties to the appeal
agree to the deviation.

(Added to NAC by Comm’r of Insurance by R006-03, eff.
12-16-2003)

NAC 616B.9914Meetings. (NRS 616B.790)All
meetings of the Appeals Panel must be conducted in compliance with the
provisions of chapter 241 of NRS.

1. To file a grievance with the Appeals
Panel pursuant to NRS 616B.772,
the petitioner must submit a written request for a hearing by United States
mail or by electronic means in the manner set forth in NRS 719.250 to the Division of
Insurance at one of the following addresses:

Division of Insurance

Department of Business and Industry

1818 East College Parkway, Suite 103

Carson City, Nevada 89706

Electronic mail address:
insinfo@doi.state.nv.us

Facsimile copy: (775) 687-0787

Telephone: (775) 687-0700

2. The request for a hearing must include,
without limitation:

(a) A statement which requests a hearing;

(b) A clear, simple statement which describes the issues
in dispute and the relief requested; and

(c) A description of any statutes, rules, agency
decisions or other authorities that the petitioner believes may be relevant to
the issues in dispute or the relief requested.

3. The petitioner may withdraw the request
for a hearing at any time before the date set for the hearing by sending
written notice of the withdrawal in the same manner as set forth in subsection
1 for submitting a request for a hearing.

1. A person, other than an original party to
a hearing, who believes that he or she may be directly and immediately affected
by the hearing and who wishes to participate in the hearing as an intervener,
must secure an order from the Chair granting the person leave to intervene.

2. To seek an order for leave to intervene,
the person must file with the Division of Insurance, not later than 2 days
before commencement of the hearing, a petition for leave to intervene and proof
of service of copies of the petition on each party to the hearing. If the
petition and proof of service are filed later than 2 days before commencement
of the hearing, the petition must state a substantial reason for the delay. If
such a substantial reason for the delay is not stated in the petition, the
Appeals Panel shall not consider the petition.

3. A petition for leave to intervene:

(a) Must be in writing;

(b) Must clearly identify the hearing in which the
person seeks leave to intervene;

(c) Must set forth the name and address of the
person seeking leave to intervene;

(d) Must contain a clear and concise statement
which sets forth:

(1) The direct and immediate interest of the
person in the hearing; and

(2) The manner in which the person may be
affected if he or she is not granted leave to intervene;

(e) Must outline the information the person relied
upon as the basis for seeking leave to intervene; and

(f) If affirmative relief is sought, must contain a
clear and concise statement regarding the relief sought, the basis for seeking
such relief, and the nature and quantity of evidence the person may present at
the hearing if granted leave to intervene.

(Added to NAC by Comm’r of Insurance by R006-03, eff.
12-16-2003)

NAC 616B.992Conflict of interest of member who represents Division of
Insurance. (NRS 616B.782,
616B.790)A member
of the Appeals Panel who represents the Division of Insurance shall be deemed
not to have a conflict of interest pursuant to NRS 616B.782 with respect to the
Division of Insurance if the Division of Insurance is a party to the hearing or
has been involved in the handling of the appeal.

1. Not later than 30 days after the receipt
of a request for a hearing, the Chair shall set a date for the hearing. The
hearing must be conducted not later than 90 days after the receipt of the
request for a hearing, at such time and place as the Chair prescribes.

2. The Appeals Panel shall provide to the
parties written notice of the hearing pursuant to NRS 616B.777. The notice must
specify:

(a) The purpose of the hearing;

(b) The date, time and location of the hearing; and

(c) Any other information required pursuant to the
provisions of NRS 233B.121.

1. The Appeals Panel shall conduct hearings
as informally as possible under the circumstances.

2. The Appeals Panel shall direct their
efforts toward promoting consistency and fairness in all decisions while
ensuring compliance with all rules pertaining to classifications, rating and
experience modifications.

1. During any hearing, the Chair may
formally order any party to the hearing to file a brief or a statement of facts
with the Chair by a date set by the Chair.

2. The party shall file with the Chair the
brief or statement of facts and proof of service of copies of the brief or
statement of facts on all other parties to the hearing.

3. The Chair may extend the time for filing
the brief or statement of facts if a party requests such an extension before
the date set for filing. The Chair shall issue a decision to grant or deny the
extension in writing.

(Added to NAC by Comm’r of Insurance by R006-03, eff.
12-16-2003)

NAC 616B.9934Burden of proof; order of presentation; continuances and
recesses; failure of petitioner to appear. (NRS 616B.790)

1. The petitioner has the burden of proof in
a hearing.

2. During each hearing, unless otherwise
ordered by the Chair in a specific case, the Chair and parties will ordinarily
present the following information in the following order:

(a) A brief orientation by the Chair.

(b) Testimony and other evidence that addresses the
issues in dispute and the relief requested by the petitioner.

(c) Testimony and other evidence by any
interveners.

(d) Testimony and other evidence by the respondent.

(e) Rebuttal testimony and other evidence by the
petitioner.

3. The Appeals Panel may grant continuances
or recesses before or during a hearing.

4. If a petitioner fails to appear before
the Appeals Panel at the time and place set for the hearing, the Appeals Panel
may:

(a) Dismiss the hearing with or without prejudice;
or

(b) Recess the hearing for a period set by the
Appeals Panel to enable the petitioner to attend.

1. Hearings will not be conducted according
to the technical rules of evidence. Any relevant evidence may be admitted,
except where precluded by law, if it is of a type commonly relied upon by
reasonable and prudent persons in the conduct of their affairs, even though the
evidence might be subject to objection in civil actions.

2. “Hearsay evidence,” as that term is used
in civil actions, may be admitted to supplement or explain other evidence.

3. “Incompetent evidence,” as that term is
used in civil actions, is not admissible, with the exception of hearsay
evidence as provided in subsection 2.

4. Irrelevant, cumulative and unduly
repetitious evidence is not admissible.

5. The rules of privilege must be applied as
they are applied in civil actions.

(c) Must include a statement regarding the right of
the parties to appeal;

(d) Must be issued by the Chair not later than 30
days after the completion of the hearing unless the Appeals Panel orders an
extension of time to reconvene to consider additional information; and

(e) Must be delivered, in person or by first-class
mail, to the petitioner and each respondent and intervener in the hearing.

2. Decisions of the Appeals Panel may be
appealed pursuant to the provisions of NRS 616B.787 and 679B.310.

3. A party wishing to appeal the decision of
the Appeals Panel must direct the appeal to the Commissioner. The Commissioner
will conduct the hearing for such an appeal pursuant to the provisions of NRS 679B.310 to 679B.370, inclusive.